ICLC 5
K.U.Leuven
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Registration

 

 

iclc5 :: Registration
 

Fields marked with * are required fields. Fields marked with (*) are required if applicable.

Title: 
*First Name: 
*Surname: 
*E-mail: 
Home-page: 
*Affiliation: 
Position: 

*Postal address: 
 
Postal address 2: 
 
*Zip Code: 
*City: 
State/Province: 
*Country: 

Member of K.U.Leuven Association:  yes  no

Language of Presentation: 

*Mode of Payment: 
  bank transfer 150 euros (transfer instructions will be sent to you by email)
  credit card 150 euros (Visa, Mastercard: for security reasons, you will be asked to fax your credit card details)
  cash on site: 170 euros (only remaining possibility after June 15th, 2008)

*Conference Dinner (30 euros):  yes  no
*Historic city walk (free, sunday evening):  yes  no
*Lunches (included):  yes  no
(*)Dietary preferences:  No specific preference  vegetarian

Invoice address (if different from participant address): 
 

Total amount due:   ———  



K.U.Leuven - CWIS Copyright Katholieke Universiteit Leuven | Comments on the content: iclc5@arts.kuleuven.be
Production: Dirk Speelman | Most recent update: Oktober 24, 2007
URL: http://www.arts.kuleuven.be/iclc5