Registration form

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$year=”2014″;
$title=”2014: Crystal (cl)Year”;
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By registering, you engage yourself in paying the registration fee and in participating in the [insert_php] echo $title; [/insert_php] Meeting.


Yes, I want to register to the [insert_php] echo $title; [/insert_php] Meeting.

I’m therefore communicating the following information (fields marked with * are mandatory):

Name *
Surname *
Email address * Check carefully your email!
Laboratory/Department   Use only letters from the English alphabet!
Institute/Company * Use only letters from the English alphabet!
Address   Use only letters from the English alphabet!
Town * Use only letters from the English alphabet!
Postal code  
Country *  
 
Social Dinner   I will participate in the Social Dinner Participation in the Social Dinner is NOT included in the fee.
The Social Dinner fee is 30.00 € for participants and 40.00 € for accompanying persons.
Participants must add the dinner fee when paying for their registration.
Accompanying persons are welcome to pay on site.
The Social Dinner will be held on Thursday October 16, 2014.
Payment method * Bank transfer   Credit card Pay your fee by bank transfer or credit card BEFORE registering.
Remember to include the dinner fee. Please see payment instructions.
Payment code *  
Category / fee * Student (150.00 € within July 31, 2014, 200.00 € later)
Academy/No profit (250.00 € within July 31, 2014, 300.00 € later)
Industry (400.00 € within July 31, 2014, 500.00 € later)		  
Reduction None
AIC member    		A reduction of 30.00 euro applies to registration fees for these categories.
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