211-pae conference Registration form

RILEM TC 211-PAE FINAL CONFERENCE

Concrete in Aggressive Aqueous Environments,

Performance, testing and modeling

03-05 June 2009, Toulouse, France
Registration Form
To be filled and sent by email, mail or fax to:

[e-mail]

Miss Patricia Jarry

INSA

INSATRANSFERT–SAIC

135 Avenue de Rangueil

31077 Toulouse Cedex 4 FRANCE

Fax: [phone]
Name: ……………………………………………………Title:…………….

First name:……………………………………………………………..

Company/Organization:………………………………………………………………

Professional address:…………………………………………………..

…………………………………………………………………………..

…………………………………………………………………………..

Email:

Phone:…………………………………..

Fax:……………………………………
Participant at the conference 

RILEM member  RILEM non-member  211-PAE member 

Subscribing to: Conference  Technical day¹ 
Accompanying person  Number ……….

Accompanying person subscribing to: Conference Dinner  Social Programme^{2 3}


Registration fees are not submitted to Value Added Taxes
Fees: please make your choice among the following fees:

		2009	€/pers.	Your choice
Conference (3-4 June 2009)	RILEM member	Before 01 April	280
		After 01 April	320
	RILEM non-member	Before 01 April	310
		After 01 April	360
	TC-PAE member		150
Technical day (5 June)			60

Accompanying person	Conference Dinner	50
	Social programme	120* *To be paid at the conference registration desk

Total cost:

Methods of payment:
 By cheque payable to "l’Agent Comptable de l’INSA de Toulouse".

 By credit card

 VISA  MASTER CARD/EUROCARD

Card number: ……………………………………

Expiration date:…………………………………

Signature:

 By bank transfer to:

AC INSA – 135, avenue de Rangueil

TRESORERIE GENERALE TOULOUSE : 10071.31000.00001001324 97

BIC : BDFEFRPPXXX

IBAN : FR76 1007 1310 0000 0010 0132 497

N° SIRET : 193 101 524 000 18

N° VAT : FR20 193 101 524
Registration includes (i) participation in the conference, coffee breaks and lunches, conference dinner (03 June 2009) and (ii) the printed proceedings.
No reimbursement will be made for cancelation after 15 May 2009.

1^,2 See conference website for the programme.

2

3 Registration to the social programme must be made before the 15^th of April 2009