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ICSEA '98


INDIVIDUAL REGISTRATION FORM


Please use one form per person

Form to be returned

 

by post mail :

CNAM - CMSL

292, rue Saint-Martin

75003 PARIS - FRANCE

 

or Fax :

+ 33 ( 0 ) 1 40 27 23 77


 

Ms [  ]   Mr [  ]

Last Name :

First Name :

Title :

Organization :

Address :

 

Postal/Zip code :

City :

Country :

Phone :

Fax :

Email :

 

Please tick as appropriate

Standard fee* University fee* Student fee*

3 days

FF 4 600 [  ] FF 2 600 [  ] FF 600 [  ]

2 days
8 [  ]   9 [  ]   10 [  ] December

FF 3 500 [  ] FF 2 000 [  ] FF 400 [  ]

1 day
8 [  ]   9 [  ]  10 [  ] December

FF 2 000 [  ] FF 1 200 [  ] FF 300 [  ]
Proceedings

FF 300 [  ]

Lunches

Tuesday 8 FF 150 [  ]

Wednesday 9 FF 150 [  ]

Thursday 10 FF 150 [  ]

Total  

* VAT Include

 

I plan to attend the following sessions
( please tick as appropriate )

1  [  ] 2  [  ] 3  [  ] 4  [  ] 5  [  ] 6 [  ] 7  [  ] 8  [  ]
9  [  ] 10  [  ] 11  [  ] 12  [  ] 13  [  ] 14  [  ] 15  [  ] 16  [  ]

 

Tranportation discount

I would like to receive:

[  ] The French Railways ( SNCF ) discount form

[  ] The Air France discount form - Agreement n° SC24862


PAYMENT

ONLY THOSE APPLICATIONS RECEIVED WITH PAYMENT ENCLOSED WILL BE HONOURED

 

Please find enclosed a check payable to Agent Comptable du Conservatoire des Arts et Métiers in the amount of FF ..........................

corresponding to the amount mentioned above

 

Please transfer to the account :

30041 00001 0906301R020 13

Swift 40 46-2

Réf : BDF EFRPT-CCT

Please inform your bank that the transfer fees are to be paid by the issuer, and bring a copy of the Swift transfer with you
 

 

Date.......................................................Signature
 
 

 

 

 

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Program at a glance

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