ESS'99
October 26-28, 1999
FAX/MAIL REGISTRATION FORM
(or use the electronic form)

Please legibly print or type and fill out completely.

FIRST NAME
 		 LAST NAME
  		M.I.
 
COMPANY OR AFFILIATION
 
Mailing address (tick one): [ ] HOME [ ] BUSINESS
STREET
 
CITY
 
ZIPCODE
 		 COUNTRY
 
TELEPHONE
 		 FAX
 
E-MAIL
 
DATE
 		 SIGNATURE
 

 

REGISTRATION AND PAYMENT
A.CONFERENCE REGISTRATION (Check appropriate boxes)
1. [ ] SCS member   EURO 425
        Member Number:_____________________________ 		EURO
___________
2. [ ] Members of Sponsor or Affiliate Society
        EURO 425
        Circle your affiliation: EUROSIM JSST CASS CSSS HSS LSS PSS TSS 		EURO
___________
3. [ ] Non-Member Participant
        EURO 475		 EURO
___________
4. [ ] For registration AFTER October 5, add
        EURO 50		 EURO
___________
5. [ ] Students, who are not authors but who wish to attend the conference pay:
        EURO 225		 EURO
___________
6. [ ] One Day Registration:
        EURO 230		 EURO
___________
(Above registration fees include, TUTORIALS, one copy of the PROCEEDINGS-CD-Rom, all midday meals, cocktail, refreshments, coffees and social program, except for students where the Conference Proceedings are NOT INCLUDED.)  
7. [ ] 1 Week Java Tutorial Registration
        EURO 1280 		EURO
___________
8. [ ] 1 Day Object Orientation Tutorial Registration
        EURO 245		 EURO
___________
9. [ ] 1 Day Virtual Reality Tutorial Registration
        EURO 245		 EURO
___________
10. [ ] 1/2 Day High PerformanceSimulation Tutorial Registration
        EURO 160		 EURO
___________
11. [ ] 1/2 Day Field Programmable Devices Tutorial Registration
        EURO 160		 EURO
___________
12. [ ] Conference Dinner Ticket for Companion
        EURO 35 		EURO
___________
13. [ ] Subsciption to "Simulation"
        EURO 85 		EURO
___________
VAT Number if applicable: _______________________________
TOTAL AMOUNT DUE EURO
___________
ADD BANK CHARGE of EURO 10 in case you pay by BANK or CHEQUE. EURO
___________
TOTAL AMOUNT REMITTED EURO
___________

[ ] 1)
Make payment by BANK TRANSFER to account No. 290-0033837-05 SCS Europe BVBA, GENERALE BANK, Branch Office Ghent Centre, Kouter 8, B-9000 Ghent, Belgium MENTION YOUR NAME and ESS'99
SWIFT CODE: GEN: GEB-ABEBB-05A
[ ] 2) Or pay by CHEQUE and send it to SCS European Office, European Simulation Office, University of Ghent, Coupure Links 653, B-9000, Ghent, Belgium.
[ ] 3) Or pay by CREDIT CARD and fill in the information below:
Charge my (tick one): [ ]Visa [ ] Euro/Mastercard [ ] American Express [ ]Diners

CARD NO: __ __ __ __ : __ __ __ __ : __ __ __ __ : __ __ __ __ EXP.DATE: __ __ / __ __

Authorizing Signature:
  

PURCHASE ORDERS ARE NOT ACCEPTED UNLESS GUARANTEED BY A CREDIT CARD NUMBER.

MAIL REGISTRATION FORM AND PAYMENT FORM COPY (1) / CHEQUE (2) / CREDITCARD INFO (3) TO:
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