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ECMI 98

10th Conference of the European Consortium for
Mathematics in Industry

REGISTRATION AND ACCOMMODATION FORM

FAMILY NAME.....................................................................................FIRST NAME........................................................................

PROFESSION/TITLE.........................................................................................................................................................................

INSTITUTION.................................................................................................................................................................

CORRESPONDENCE ADDRESS.....................................................................................................................................................

.....................................................................................COUNTRY.................................................................................................

E-MAIL............................................................................................................................................................................................

TELEPHONE.....................................................................TELEFAX...............................................................................................

Return this form and
payment to:

ECMI
c/o CONGREX
Box 5078
402 22 GÖTEBORG
SWEDEN
Phone: +46 31 708 82 00
Fax: +46 31 20 36 20

Price/Pers
SEK

Code

SEK

REGISTRATION

REGISTRATION FEE *

ECMI members before April 24
ECMI members after April 24
Non-members before April 24
Non-members after April 24
Students before April 24
Studentsafter April 24
STM membersbefore April 24
STM members after April 24

1300
1500
1500
1800
250
350
0
300

010
020
030
040
050
060
070
080

_____
_____
_____
_____
_____
_____
_____
_____

All the activities you intend to participate must be booked on this form and are payable in advance

110
120
130

_____
_____
_____

SOCIAL PROGRAMME*
Afternoon excursion June 24
Welcome reception June 24
Conference DinnerJune 25
*VAT 20 % included in the fee

Yes
Yes
Yes

No
No
No

Incl.
Incl.
350

ACCOMMODATION
Arrival date__________ 1998, at______________hours Departure date_______________

Special requirements e.g. dietary________________________________________________

Cancellation

All fees will be refunded for written cancellations received by Congrex before 20thApril, 1998 less SEK 255:- cancellation charge. No refunds for cancellations made after April 20th for cancellation charges

Hotel

Category A
Category B
Category C
Youth Hostel (exkl. breakfast)

All rooms have private bath or shower.
Price include VAT and breakfast.

Single room
SEK /night
1300-1600
1000-1300
600-1000
300-400

Double room
SEK/night
1600-1800
1300-1600
900-1300
400-500

No rooms can be confirmed until CONGREX has received your deposit

SEK_________
SEK_________
SEK_________

Registration fee
Social events
Hotel deposit

The reservation requires a deposit
of the first night, which will be deducted
from the final bill.

We are sorry not to be able to accept PERSONAL-, COMPANY- or EURO-CHEQUES.

GRAND

PAYMENT
All payment should be made in SEK (Swedish kronor) payable to ECMI c/o CONGREX. Please clearly
mark payment with your name and institution/organisation. Please indicate your means of payment:

Banker's draft
American Express
Visa

Bank Account SE-Banken, Göteborg, No. 5001-10 378 22
Eurocard/Mastercard
Postal giro 7738-8 (Nordic participants)

Charge my credit card No:_____________________Expiry date:________________________________

Date:_____________Signature____________________________________________________________
VAT No. SE 556479559801