Transcript SEND REGISTRATION FORMS

Workshop Registration
Title:
Name:
IEEE Member number (if applicable):
Address:
City:
State/Province:
Telephone:
Postal Code:
Fax:
e-mai address:
REGISTRATION FOR PAPER #:
Event Registration
Check

IEEE Member Full Registration
Non IEEE Member Full Registration
IEEE Student Member registration (proof of status required)
Student registration (proof of status required)
Social Dinner (17/05/2016 – not included in Full registration)
TOTAL
Early Bird
€ 240,00
€ 290,00
€200,00
€250,00
€ 50,00
After 1st
April
€ 290,00
€ 340,00
€250,00
€300,00
€ 55,00
Full registration comprehends printed proceedings, coffe breaks, welcome drink, student registration exclude welcome drink.
Social dinner is not included in registration fees
Method of Payment
Early Bird registrations can be paid only via wire transfer. Credit card facility will be present on site.
Please attach to present form receipt of wire transfer, in euro, made to:
Consorzio ARES – Advanced Research and Engineering for Space
C.F. e PART. IVA 08126751000 - Nº REA 1075511
c/o INTESA SANPAOLO - Filiale Roma 02 – Tiburtina
COD. NAZ. IT CHECK 39 CIN G ABI 03069 CAB 39152 c/c n. 1000 00061288
swift code: B C I T I T M M
IBAN: IT39 G030 6939 1521 0000 0061 288
Refund Policy
Fees include a non-refundable administration charge of € 40,00 and must be paid before a registration will be processed. Written notice oc
cancellation received by April 1st 2016 will allow full refund (less the € 40,00 non-refundable administration charge). Written notice of
cancellation received une month before the conference have an additional €50,00 cancellation fee (for a total of € 90.00). No refunds after April
16th 2016.
SEND REGISTRATION FORMS
With proof of payment and status to:
[email protected]