ESCAPE-10, The 10th European Symposium on Computer Aided Process Engineering, Florence Italy May 7-10, 2000

Please make a copy of this registration form and send it either by fax or by e-mail.

REGISTRATION FORM

First Name

 

Family Name

 

Title

Ms, Mr, Dr, Prof

Company

 

 

Mail-Address

 

 

 

City, Zip & Country

 

e-mail

 

Voice Phone

 

Fax Phone

 

 Payment of

EURO 550 (+VAT 20%) before March 31,2000

EURO 600 (+VAT 20%) after March 31, 2000

Installed by Bank Transfer (Please attach a copy of the Bank Order)

Please Charge my Credit Card

 Euro Card

Master Card

Visa

Carta Si

 Card Number

  

Card Expir. Date

 

Signature

 

 

Date

 

We Regret to inform you that cancellations after April 15th 2000, cannot be refunded