ECEC 99 |
Please legibly print or type and
fill out completely.
FIRST NAME |
LAST NAME |
M.I. |
COMPANY
OR AFFILIATION |
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Mailing address (tick one): [ ] HOME [ ] BUSINESS | ||
STREET |
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CITY |
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ZIPCODE |
COUNTRY |
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TELEPHONE |
FAX |
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DATE |
SIGNATURE |
REGISTRATION AND PAYMENT A.CONFERENCE REGISTRATION (Check appropriate boxes) |
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1. [ ] SCS member 450 EURO Member Number:_____________________________ |
EURO ___________ |
2. [ ] Members of Sponsor or Affiliate
Society 450 EURO Circle your affiliation: EUROSIM JSST CASS CSSS HSS LSS PSS TSS |
EURO ___________ |
3. [ ] Non-Member Participant 500 EURO |
EURO ___________ |
4. [ ] Students, who are not
authors but who wish to attend the conference, or
ONE DAY PARTICIPANTS pay: 250 EURO |
EURO ___________ |
(Above registration fees include, TUTORIALS, one copy of the PROCEEDINGS, all midday meals, cocktail, refreshments, coffees and social program, except for students where the Conference Proceedings are NOT INCLUDED.) | |
5. [ ]
Conference Dinner Ticket for Companion EURO 50 |
EURO ___________ |
VAT Number if applicable: _______________________________ | |
TOTAL AMOUNT DUE | EURO ___________ |
ADD BANK CHARGE of 10 EURO 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 6, B-9000 Ghent, Belgium MENTION YOUR NAME and ECEC'99 |
[ ] 2) | Or 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. |
[ ] 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:
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