ECEC 2000 -- Electronic Registration Form

ECEC 2000
Leicester, United Kingdom,
17-19 April 2000
ELECTRONIC REPLY FORM
(or use the fax/mail form)

ELECTRONIC REPLY FORM
Please note: This form does NOT work with Internet Explorer 3.02 or lower.
It does work fine with all versions of Netscape, and from version IE 4.0. onwards.

First Name:
Surname:
Occupation and/or Title:
Affiliation:
Mailing Address:
Zipcode:
City:
Country:
Telephone:
Fax:
E-mail:

Yes, I will attend the 2000 ECEC conference.

A. Conference Registration. (Fill in 1/2/3/4 and 5/6 if necessary) -
PRE-CONFERENCE PRICES VALID TILL MARCH 25TH.

1. SCS Conference Member EURO 450
SCS member number:
2. Member of Sponsor or Affiliate Society EURO 450
Affiliation Society:	Eurosim JSST CASS CSSS HSS, LSS PSS TSS
3. Non-Member participant EURO 500
4. Students who are not authors or a ONE DAY registration EURO 250
5. Extra Conference Dinner ticket for companion. EURO 50
6. Add bank charge if necessary when paying by bank transfer or cheque EURO 10
TOTAL AMOUNT TO PAY IN EURO

B. PAYMENT INFORMATION

I will make payment by BANK TRANSFER to account No. 290-0033837-05 SCS Europe BVBA, GENERALE BANK, Branch Office Ghent Centre, Kouter 6, B-9000 Ghent, Belgium SWIFT CODE: GEN: GEB-ABEBB-05A MENTION YOUR NAME and ECEC'2000 (make a print of this form so you know what you submitted) and ADD A COPY OF PAYMENT TO THIS FORM

I will pay by CHEQUE and send it to Philippe Geril, SCS European Office, European Simulation Office, University of Ghent, Coupure Links 653, B-9000, Ghent, Belgium. (make a print of this form so you know what you submitted)

I will pay by CREDIT CARD but do not send the information with the form. Please phone me for the credit card information

I will pay by CREDIT CARD and fill in the information below. Please note: credit card information is NOT encrypted in the e-mail. If this is a problem: fax the credit card information separately, or discuss the payment information with Philippe Geril by phone or by e-mail.

Type of card
Card no
Cardholder name
Exp.Date

If e-mail fails, you can also print this information and send / fax it to:
Philippe Geril, The Society for Computer Simulation International,
European Simulation Office, University of Ghent,
Coupure Links 653, B-9000 Ghent, Belgium
Phone: +32-9-2337790, Fax: +32-9-2234941