

	Multimedia Modeling 2001

Registration Multimedia Modeling 2001

Registration Costs
Conference fee (1 Dinner is included)	Student	NLG 375
	Others	NLG 475
Extra dinner		NLG 80 per extra person
Tutorials		NLG 200 per session

For more information about hotel reservation see: Hotel reservation

For registration please fill in this form. Please be aware that Given and Family name are used for the badge and that the e-mail address is required for providing you with a receipt, once the payment is processed.

Visa-related invitation requests: We regret that due to the recent proliferation of unfulfilled visa-related conference invitation letter requests, we will not deliver letters of invitation for conference participants until the payment of registration for the participants is complete.

Finally, you must be aware that no refunds will be made in cases of cancellation after 22.10.2001. Cancellations before this date will be charged with 100 Guilders to accustom administration fees.

Given name
Family name:
Affiliation:
Student
Address:
Street+Number:
City:
Country:
E-Mail address:
URL:
FAX:
Diet restrictions

Extra persons for dinner
Morning session tutorials	None Smil Virtual Universities
Afternoon session tutorials	None MPEG4


Total amount of fees


Instructions for Payment PLEASE NOTE: If we receive incomplete or wrong data of your credit card we will not process your registration
Method of Payment:
The following information will be sent unprotected. In case you wish not to do so, please print the form and fax is it (+31 20 592 4199) to Wilmy van Ojik.
Card Number:
Name Card Holder:
Expiration date:
Owners of MASTERCARD or AMERICAN EXPRESS credit cards are requested to give some additional information, which is needed by CWI for cashing the fee:
CVC code (on the signature-side of your card):
ZIP code of your credit card address (this may be different from your affiliation address):
House number:
Country (this may be different from the country of your affiliation address):
If you do not want to register by using your credit card, please transfer your fees to:
	RABO Bank
bank account no.:	31 35 57 977
owner:	Stichting W.I.C., Kruislaan 413, NL-1098 SJ AMSTERDAM
mentioning:	Multimedia Modeling 2001

Before you submit, please make sure that the form is filled in correctly.

In case of problems please contact Wilmy.van.Ojik@cwi.nl