REGISTRATION

REGISTRATION FORM:

Please download the registration forms from the following links

MS Word: Registration.doc      PDF: Registration.pdf

and fax the forms to the following address:

ICANNGA 2005
Departamento Engenharia Informática
Pólo II Universidade de Coimbra, Pinhal de Marrocos,
3030-290 Coimbra, Portugal
Fax: +351 239 701266, Phone: +351 239 79 0000
Email:icannga05@dei.uc.pt

Fill in legibly, please. The above data will be used for the list of participants

Last name:
First name:
Mr/Ms:
Title:
University / Company:
Faculty: Department:
Street: City:
ZIP CODE: Country:
Phone: Fax:
E-mail: www:

Fees

Registration Fee 430/495 before/after 15 January 2005 Euros
Additional Page
50 Euros /page Euros
Tutorials
50 Euros /tutorial

1.
2.
3.
4.
5.

Accompanying Person 120 Euros Euros
Total Euros

General Conditions
Papers will only be included in the conference proceedings (to be published by Springer-Verlag, Vienna) if at least one of the authors have registered and agreed to present the paper. Papers longer than 4 pages will be subject to an additional page charge (50 Euros per additional page). Registration fees include the following:
• A copy of the conference proceedings.
• Buffet lunches each day during the conference.
• Coffee breaks during the conference.
• Entrance to the University Chapel Organ Concert
• Participation in the welcome reception and the conference dinner.

Payment

Payment can be made via Credit Card or Bank Transfer.

Credit Card

VISA MasterCard/EuroCard Maestro Diners Club JCB
Name on CC CardNumber
CVD Code (3 last numbers at the back of your card) Validity (YY/MM)
Please charge my credit card the total amount of Euros  
Date Signature

Bank Transfer

Owner
APCA – ICANNGA’05
Bank BPI – Coimbra - Vale das Flores - Estrada da Beira, 115 – A, 3030 Coimbra
IBAN PT50 0010 0000 3440 4160 0014 8
Swift Code BBPIPTPL
ID MESSAGE ICANNGA2005 / Participant’s name

We look forward to seeing you in Coimbra during ICANNGA 2005.

ICANNGA 2005 Organising Committee