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ECPPM2000 |
REGISTRATION FORM
Please return by Fax to +351 21 295 77 86
Last Name:_________________ First Name:____________________
Prof./Dr./Mr./Ms.
Organisation:
____________________________________________________________
Mailing Address:
_________________________________________________________
________________________________________________________________________
Country:
________________________________________________________________
Phone:______________ Fax: ________________ E-mail:_________________________
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(before September 8st) 400 - 80.000 PTE x .. = ___________ |
(after September 8st) 450 - 90.000 PTE x = ___________ |
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20 - 4.000 PTE x = ___________ |
| (Monday, Tuesday and Wednesday) | |
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50 - 10.000 PTE x = ___________ |
Total = ___________ |
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Note: Registration Fee includes conference proceedings book, lunches, coffee breaks and conference dinner. |
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| Payment Can be done by: |
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| Date: __________________ Signature: __________________________________________ | |