ESS'98
October 26-28, 1998
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. We will do testing with IE 4.0.
Surname:
First Name:
Occupation and/or Title:
Affiliation:
Mailing Address:
Zipcode:
City:
Country:
Telephone:
Fax:
E-mail:

Yes, I will attend the 1998 ESS conference in Nottingham, UK.

A. Conference Registration. (Fill in 1/2/3/5 and 4/6/7 if necessary)

1. SCS Conference Member
BF 17.000 / 285 / ECU 425
SCS member number:
2. Member of Sponsor or Affiliate Society
BF 17.000 / 285 / ECU 425
Affiliation Society: Eurosim, JSST, CASS, CSSS, HSS, LSS, PSS, TSS
3. Non-Member participant
BF 19.000 / 320 / ECU 475
4. Late registration surcharge
after September 15, add: BF 2.000 / 35 / ECU 50
5. Students who are not authors
BF 9.000 / 150 / ECU 225
6. Extra Conference Dinner ticket
for companion. BF 1300 / 22 / ECU 33
7. Add bank charge if necessary
when paying by bank transfer or cheque
BF 400 / 7 / ECU 10
TOTAL AMOUNT TO PAY (BF/BP/ECU)


B. PAYMENT INFORMATION

I will make payment by BANK TRANSFER to account No. 290-0033837-05 SCS Europe BVBA, SOCIETE GENERALE DE BANQUE, Branch Office Ghent Centre, Kouter 6, B-9000 Ghent, Belgium MENTION YOUR NAME and ESS'98 (make a print of this form so you know what you submitted)
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


This page last modified 03-02-03 by Alexander Verbraeck, Delft University of Technology / SCS Europe