IUTAM REGISTRATION FORM (* required)

* PARTICIPANT

Last nameMF
Title
Initials
First name
Affiliation
Address
Zip code
City
Country
Email
Tel Fax

ACCOMPANYING PERSON (not participating the symposium)

Last nameFirst name Initials MF

ROOM SHARING (with someone participating the symposium and staying at Rolduc)

Person with whom you share the room Reduction fee
&euro -70

* REGISTRATION FEE

Registration Fee Before December 1, 2002 After December 1, 2002
Including accommodation in Rolduc Abbey1&euro 850&euro 950
Without accommodation in Rolduc Abbey2&euro 550&euro 650
Students, incl. accommodation in Rolduc Abbey1&euro 700&euro 750
  1. Registration Fee includes: accommodation in Rolduc Abbey from 18/05/2003 to 23/05/2003 (5 nights), breakfasts, lunches, dinners (excluding the conference dinner on Wednesday May 21, 2003), coffee/tea during the breaks, free use of facilities of the Abbey, welcome reception and buffet, concert, proceedings.
  2. Registration Fee includes: lunches, dinners (excluding the conference dinner on Wednesday May 21, 2003), coffee/tea during the breaks, free use of facilities of the Abbey, welcome reception and buffet, concert, proceedings.

ACCOMPANYING PERSON (not participating the symposium)

Registration Fee
Including accommodation in Rolduc Abbey1&euro 350
Without accommodation in Rolduc Abbey2&euro 225
  1. Registration Fee includes: accommodation (roomsharing) in Rolduc Abbey from 18/05/2003 to 23/05/2003 (5 nights), breakfasts, lunches, dinners (excluding the conference dinner on Wednesday May 21, 2003), coffee/tea during the breaks, free use of facilities of the Abbey, welcome reception and buffet, concert, social program. Excluding access to the lectures.
  2. Registration Fee includes: lunches, dinners (excluding the conference dinner on Wednesday May 21, 2003), coffee/tea during the breaks, free use of facilities of the Abbey, welcome reception and buffet, concert, social program. Excluding access to the lectures.

TOUR AND CONFERENCE DINNER, Wednesday, May 21, 2003

Conference dinner incl. Tour to Eindhoven University of Technology, visit to the laboratories, May 21 2003&euro 85
Tour to Eindhoven University of Technology, visit to the laboratories, excl. conference dinner&euro 15

SPECIAL DIET REQUIREMENTS

If you have special diet requirements please let us know.

PAYMENT

FareAmount
Registration FeeSee table above&euro
Registration Accompanying personSee table above&euro
Reduction feeSee table above&euro
Conference Dinner, incl. Tour&euro 85 x person(s)&euro
Tour to TUE, laboratories&euro 10 x person(s)&euro
Total&euro

WAY OF PAYMENT

Please state clearly your name on the bank transfer. We have to insist that you cover all costs of this bank transfer.
Registration will become final went fee has been received.
Bank Transfer in euro to:
Account nameStichting Materials Technology
Bank NameABN-AMRO
Bank AddressTongelresestraat 256a, P.O. Box 6058, 5600 HB Eindhoven, The Netherlands
SwiftcodeABN.ANL.2A
Account No60.77.67.715
Mentioning'IUTAM symposium' and your name
Tel. Bank+31.40.2440058

CANCELLATION

Cancellation received before April 15, 2003, will permit a refund with a deduction of 50% costs. If cancellation is received after April 15, 2003, the full conference fee will be charged. (Balance will be refunded after the Conference.)
NOTE: All cancellations or changes must be received by the Secretariat in writing or fax.

Please fax to +31-402447355

or send to Y. Biemans,
Biomedical Engineering,
TUE,
P.O. Box 513,
5600MB Eindhoven,
The Netherlands.