Registration  Form

Family Name:
 		First Name :
 		Telephone / Fax:
 		E-mail :
Address :
 		Postal Code :
 		City :
 		Country :

Please indicate
 Before May, 30 After May, 30
Senior Participant:  250 Euros  Senior Participant:  300 Euros
Student: (*) 150 Euros  Student: (*) 200 Euros
Accompanying person:   60 Euros  Accompanying person:   90 Euros
(*) Undergraduate or PhD (postdocs should register as senior participants)
Total amount of registratión-fees..:      
 

REGISTRATION FEES INCLUDE:
 Congress information, participation in all the sessions, welcome cocktail, coffe break, lunches and guided visit to old city.

ACCOMPANYING PERSON FEES INCLUDE:
 Welcome cocktail, coffe break, lunches and guided visit to old city.

Excursion Low Estuaris 30 Euros Official Dinner 40 Euros
 

                                 TOTAL AMOUNT ......:       

Notes:
METHODS OF PAYMENT
 By (international) bank transfer addressed to Viajes Atlántico. Banco Popular Español OP Santiago de Compostela
     IBAN-code: ES17 0075 0396 72 0500008580 / Swift-code: POPUESMM.
TPV Virtual (SSL) By Credit Card On Line.

“Following L.O. 15/99 of  Data Protection of Personal Condition, we inform you that yours personal particulars will be at Viajes Alántico´s datafile only to be used for the above meeting. Filling the present form, authorize Viajes Atlántico to use your personal particulars. You could access, rectify or cancel anyway at ours offices”