EAMT/CLAW 2003

Registration Form

Required fields marked by asterisk *
*Name
Title
Department
Company/Org
* Address
* City
Postcode
* Country
Telephone
Fax
* Email Please be sure you enter your email address correctly. Otherwise, you will not receive an automatic reply nor will we be able to contact you.
Website

* EAMT member?
Yes:   EAMT Member
No:   Non-member

If you are not a member, you can join the EAMT by filling in a membership form.

List of participants
We would like to include names and organizations who have registered to be listed on the EAMT-CLAW website. If you would prefer that your name and name and organization is NOT listed, please check this box:

Please do not list my name and organization on the EAMT-CLAW website.

A full list of participants will be included in the printed conference programme.


Registration Fees

Please select the appropriate registration fee:
Early Registration
(up to 31 March)

Late Registration
(from 1 April)

EAMT member ordinary

€ 180

€ 230

EAMT member student € 120 € 230
Non-member ordinary € 220 € 300
Non-member student € 150 € 300

Please enter the corresponding amount here:
* Conference fee: €


Dietary Requirements
Please indicate if you require any of the following types of meals:
vegetarian during conference
vegan during conference
kosher during conference
other (please specify):
during conference at banquet


Please calculate total and enter it here: * Total payment: €


Method of Payment

Payment by credit card is preferred. Please use bank transfer only if you do not have this option.

Credit card (Mastercard or VISA only)
 Name on card
 
 Card Number Expiration Date
 
Bank transfer (in euros, copy enclosed) to account number 351.091.60Q
UBS, Bahnhofstrasse 45, CH-8021 Zürich, Switzerland
Swift code: UBSWCHZH40M
Please note: all bank transfer charges must be borne by applicant.
Cheque, payable to EAMT

To pay offline (by credit card, cheque or bank transfer), please print out this form and send it (by mail or by fax) to:

EAMT Secretariat, c/o ISSCO 40, boulevard de Pont-d'Arve
CH-1221 Genève
Switzerland
Fax +41 22 705 8689




Social Events

To help us estimate numbers for social events attached to the conference, we would be grateful if you could indicate your intention to attend the following receptions by ticking the relevant boxes. Admission is free to both receptions!

Additional events

I intend to attend the Wine Reception at DCU on Wednesday, 14 May Number of persons:
I intend to attend the Civic Reception at The Mansion House in Dublin on Thursday, 15 May Number of persons:



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  Last updated: 28 Apr 2003