Amsterdam, May 8-10, 2000
REGISTRATION FORM
please return as soon as possible, BY REGULAR MAIL OR BY FAX (as a hard copy) and NOT by e-mail (which will not be accepted), preferably before April 8th, 2000 please print or use a typewriter o Mr o Ms Family name ____________________________________________________________________ First name ________________________________ Title ______________________________ Function ____________________________________________________________________ Institution ____________________________________________________________________ Address ________________________________________________________________________ Code / City ____________________________________________________________________ Country ________________________________________________________________________ Telephone ______________________ Telefax _______________________________________ E-mail _________________________________________________________________________ Please tick the appropriate boxes and fill in the appropriate amounts HPCN EVENT - FULL TIME fee amount I wish to attend the full HPCN event to be paid SCIENCE o Registration and payment before April 8th, 2000 DFL 850 DFL _____ o After April 7th, 2000 DFL 1050 DFL _____ INDUSTRY o Registration and payment before April 8th, 2000 DFL 1150 DFL _____ o After April 7th, 2000 DFL 1350 DFL _____ HPCN EVENT - FOR ONE DAY fee amount I will attend the HPCN event on the following day only: to be paid o Monday, May 8, 2000 o Tuesday, May 9, 2000 o Wednesday, May 10, 2000 SCIENCE o Registration and payment before April 8th, 2000 DFL 350 DFL _____ o After April 7th, 2000 DFL 450 DFL _____ INDUSTRY o Registration and payment before April 8th, 2000 DFL 450 DFL _____ o After April 7th, 2000 DFL 550 DFL _____
Please note that the 'one-day' fee only applies for those who wish to attend the conference for one day! For two days the full fee applies. SOCIAL PROGRAM fee per amount o I wish to register for the conference dinner person to be paid on May 9th, 2000: _____ person(s) x DFL 100 DFL _____ CONFERENCE FEES The conference fee includes access to all scientific lectures and workshops, the official welcome reception, lunches, coffee and tea. Furthermore, the proceedings are included in the FULL TIME conference fee and are NOT included for those registering for one day. Proceedings can be acquired seperately. Those who fill in the amount which applies for representatives of 'science', must also indicate their scientific institution on the registration form! TOTAL AMOUNT TO BE PAID Conference fee DFL ______________________ Social program DFL ______________________ Total amount to be paid DFL ______________________ PAYMENT I will pay the total amount of DFL ______________________ : o by remitting the amount to the Postbank Amsterdam, account number 6391427, in favour of 'UvA GIO Congresbureau'* o by sending Eurocheques to the Conference Office* (max. amount per cheque: DFL 300,-; each cheque complete with signature and bank card number) o by credit card o Master/Eurocard o Visa o American Express credit card number __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ expiration date _____________________________________________________ name card holder _____________________________________________________ * Please state "HCPN" and the full name of the participant on the bank transfer or cheque! Payments should be made in Dutch guilders and without any additional charges to the beneficiary. CANCELLATIONS AND REFUNDS The Conference Office should be notified of cancellations in writing. If cancellations are received by the Conference Office before April 8th, 2000, the total conference fee less DFL 45 administration costs will be refunded. After April 8th, 2000, no refunds will be made. Please note that refunds will only be made after the completion of the conference. By sending in this registration form, I acknowledge that I commit myself to the immediate payment of the full conference fee. I have taken notice of the cancellation terms on this form. Date _________________ Signature ________________________________________please return as soon as possible, preferably before April 8th, 2000, to the address below and make sure you send all pages of the registration form!
Conference Office
Universiteit van Amsterdam
Spui 21
1012 WX, Amsterdam
The Netherlands
Fax: + 31 20 525 4799