III EUROPEAN SPELEOLOGICAL CONGRESS
REGISTRATION FORM
Dead-line for registration on the Pre-Congress Excursions and Speleo Camps: 10 September 1999
INDIVIDUAL FORM
Personal identification:
Mrs. Mr.
First name: Family name:
Home address: Country: Keep confidential
Tel. E-mail:
Institution:
Contribution to the congress:
Paper , Poster, Exhibition, Other:
Title1:
Title2:
AV media required: Please choose one option None Slides Computer presentation Transparents Poster support Exposition support Video Other Other:
Lisbon accommodations (to pay in Lisbon):
From to (#nights)
Fees:
Free
Total payment
Method of payment:
How to Pay: By bank transfer or by cheque made payable to: Account name: Sociedade Portuguesa de Espeleologia Inter Bank Identification Number: 0007 0101 00765500005 74 Account number: 101/76550/000.5 Bank: Banco Espirito Santo Rua do Comércio, No 95 1100 Lisboa - Portugal
Please note: charges on bank orders are to be borne by the sender.
I send: cheque or copy of bank transfer No./Ref.
I send:
cheque or copy of bank transfer
No./Ref.
NOTES:
Printable Registration Form
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