the registration form
Transcription
the registration form
The Third International Workshop on Artificial Neural Networks in Pattern Recognition ANNPR 2008 An IAPR Workshop, July 2-4, 2008 Pierre & Marie Curie University, Paris, France website : http://www.c2s-organisation.com/ANNPR08 REGISTRATION FORM Please print, complete in block letters, sign and return this form to: Congrès Scientifiques Services (C2S) Chantal Iannarelli 2 rue des Villarmains – 92210 SAINT CLOUD (France) Fax : 33 1 47 71 90 04 - E-mail (attachment): [email protected] A- Prof. PARTICIPANT Dr. Mr. Ms. First Name : ............................................... Last Name :......................................................................................... Organisation : ......................................................................................................................................................... Dept/Laboratory : .................................................................................................................................................... Mailing Address : .................................................................................................................................................... ................................................................................................................................................................................. Zip/postal code : ………………City : …………………………..Country : ………………………….. Phone : .................................. Fax : ............................................ E-mail : ........................................................... I PRESENT A PAPER YES NO REGISTRATION FEES Full IAPR Members Full non members Reduced Students* Industrials Before May 9, 2008 370 € 400 € 270 € 450 € After May 9, 2008 450 € 480 € 350 € 550 € (*) a copy of the student card will be requested IAPR Membership number: Registration fees include admission to the sessions, workshop proceedings, three lunches (July 2, 3 & 4), coffee breaks and social program (Seine river cruise, visit of the Musée d’Orsay and banquet). B - ACCOMPAGYING PERSON(S) : 130 € Registration fees for Accompanying Person include social program. Mr. Ms. First Name : ……………..….Last Name : ………………………….. TOTAL : A (Participant) …….. € + B (Accompanying Persons) ……….€ = ……….. € : Check libelled in € : ANNPR 2008 / CONGRES C2S Bank transfer in € to ANNPR2008/ CONGRES C2S Bank : CREDIT AGRICOLE-CMDS - Agence de Melle - 3 Place R. Groussard - 79500 MELLE (F) Code banque: 11706 – Code guichet : 00017 –Compte n° 5306832xxxx Clé RIB: xx IBAN FR76 1170 6000 1753 0683 2702 027 SWIFT CODE : SWIFT AGRIFRPP817 Credit Card: VISA MASTER CARD EURO CARD I I I I I Security code I Card number I I I I I I I I I I I I I I Cardholder’s Name :. ........................................................ Expiration date I I __ I I I I undersigned, give the authorisation to C2S to charge my credit card for the total above : ................................. Euros I I I Signature : The Third International Workshop on Artificial Neural Networks in Pattern Recognition ANNPR 2008 An IAPR Workshop, July 2-4, 2008 Pierre & Marie Curie University, Paris, France website : http://www.c2s-organisation.com/ANNPR08 ACCOMMODATION FORM Please print and complete in block letters and return this form to: Congrès Scientifiques Services (C2S) ANNPR 2008 - Chantal Iannarelli 2 rue des Villarmains – 92210 SAINT CLOUD (France) Fax : 33 1 47 71 90 04 - E-mail (attachment): [email protected] A- Prof. PARTICIPANT Dr. Mr. Ms. First Name: ................................................. Last Name:......................................................................................... Organisation: .......................................................................................................................................................... Dept/Laboratory: ..................................................................................................................................................... Mailing Address: ..................................................................................................................................................... ................................................................................................................................................................................. Zip/postal code: .………………City: …………………………..Country : ………………………….. Phone: .................................... Fax: ............................................. E-mail: ........................................................... HOTEL ACCOMMODATION IN PARIS (Please indicate your choice) The prices are in EUROS per room, per night (breakfast and local taxes not included). Minimum one night deposit required. This deposit will be deduced from your final bill. Full payment directly to the hotel. HOTELS LOCATED IN: Quartier Latin* Montparnasse Category Single A - ** 80/ 90 € B - **Superior 90/100 € * Price’s can be more expensive I reserve Single Near the Conference* Double 90/100 € 100/125 € Twin 95/110 € 110/130 € Double (large bed) Date of arrival: …./ 07/2008 Opera No Preference Deposit * 60 € 90 € Twin (2 beds) HOTEL Category: ……….. Date of departure:... / 07/2008 Number of nights : TOTAL = Deposit (1 Night) + 9 euros (reservation charge) = Payment should be made by Check libelled in € : ANNPR 2008 / CONGRES C2S Credit Card: VISA Card number I I I I I MASTER CARD I I I I I I I I I I EURO CARD I I I I security code I I Cardholder’s Name: ................................... Expiration date I I II I I undersigned, give the authorisation to C2S to charge my credit card for the total above : .............................Euros I I I Signature :