Registration Form: AIVC Conference 2005 'Ventilation in relation to the Energy Performance of Buildings'
Hotel President WTC, Brussels, Belgium, 21-23 September 2005
 
Name  
Mr Mrs Ms
Institution 
Street
  Number
Town / City  
  Zip / Postal code
State / Province  
Country  
Phone  
    Fax
E-mail  
 VAT number
 
Please complete the appropriate sections below:
 

Conference attendance (i.e. without accommodation)
Includes: conference proceedings, lunches (21,23 Sep), dinner poster session (22 Sep)
welcome coffee & coffee/tea breaks (3 days)
 

847 €
(700 € excl. VAT)*
Conference attendance for students (i.e. without accommodation)
Includes: conference proceedings, lunches (21,23 Sep), dinner poster session (22 Sep)
welcome coffee & coffee/tea breaks (3 days)
484 €
(400 € excl. VAT)*

* VAT-registered customers should include their VAT registration number with their subscription. All prices are in EURO (€)


Methods of payement
I hereby forward the amount of € (reference 'AIVC Conference 2005')

    by bank transfer, payable to INIVE EEIG, IBAN : BE52 4348 2089 2109 - Bank Identifier Code : KRED BE BB

I hereby authorize INIVE EEIG to charge € to my credit card for registration.

       VISA Eurocard-Mastercard American Express
       Credit card number Expiration Date
       Full name of cardholder as it appears on the card

Date ………………………………………………          (Cardholder's) Signature …………………………………………………

Please return this completed registration form to Mr. Stéphane Degauquier, AIVC Conference Secretariat
INIVE, Lozenberg 7, 1932 St-Stevens-Woluwe, Belgium - Fax : +32.2.653.07.29 - Tel : +32.2.655.77.70 - e-mail : conferences.inive@bbri.be

*** Print this form before you sign and send it ***