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MESM'2000

Electronic Registration Form

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ELECTRONIC REGISTRATION FORM (or use the fax-reply form)


ELECTRONIC REPLY FORM
Please note: This form does NOT work with Internet Explorer 3.02 or lower.
It does work fine with all versions of Netscape, and from  version IE 4.0. onwards

 

First Name:
Surname:
Occupation and/or Title:
Affiliation:
Mailing Address:
Zipcode:
City:
Country:
Telephone:
Fax:
E-mail:

Yes, I will attend the 2000 MESM workshop in Amman, Jordan.

 

A. Conference Registration. (Fill in 1/2/3/5 and 4/6/7 if necessary)

1. SCS Conference Member
$ 450 / EURO 450
SCS member number:
2. Member of Sponsor or Affiliate Society
$ 450 / EURO 450
Affiliation Society: Eurosim, JSST, CASS, CSSS, HSS, LSS, PSS, TSS
3. Jordanian participant
$ 185 / EURO 185
4. Arab participant
$ 200 / EURO 200
5. Non-Member participant
$ 475 / EURO 475
6. Late registration surcharge
after August 15,
add: $ 50 / EURO 50
7. Students who are not authors
$ 125 / EURO 125
8. Extra Conference Dinner ticket
for companion. $ 40 / EURO 40
9. Add bank charge if necessary
when paying by bank transfer or cheque
$ 15 / EURO 15
TOTAL AMOUNT TO PAY ($/EURO)


B. PAYMENT INFORMATION

I will make payment by BANK TRANSFER to account No. 290-0033837-05 SCS Europe BVBA, FORTIS BANK, Branch Office Ghent Centre, Kouter 6, B-9000 Ghent, Belgium IBAN CODE:BE9629003383705, SWIFT CODE:GEN:GEBABEBB-05A. MENTION YOUR NAME and MESM'2000 (make a print of this form so you know what you submitted)
I will pay by CHEQUE and send it to SCS Europe Office, SCS European Office, European Simulation Office, University of Ghent, Coupure Links 653, B-9000, Ghent, Belgium. (make a print of this form so you know what you submitted)
I will pay by CREDIT CARD but do not send the information with the form. Please phone me for the credit card information
I will pay by CREDIT CARD and fill in the information below. Please note: credit card information is NOT encrypted in the e-mail. If this is a problem: fax the credit card information separately, or discuss the payment information with SCS Europe Office by phone or by e-mail.
Type of card
Card no
Cardholder name
Exp.Date

 

If you would like to receive more information about SCS and its activities, please tick the following box:
YES, I would like to know more about SCS.
NO, please remove me from your database.

 

If e-mail fails, you can also print this information and send / fax it to:
SCS Europe Office, The Society for Computer Simulation International,
European Simulation Office, University of Ghent,
Coupure Links 653, B-9000 Ghent, Belgium
Phone: +32-9-2337790, Fax: +32-9-2234941


Page created by SCS Europe Office. Last update 03-02-03.
Copyright SCS Europe Bvba and SCS International - All Rights Reserved