Workshop on Geometry compression, november 6-7 2003
Registration form
dead line : passed, but you still can register !


To fill in, print and send by fax or surface mail before september 19, 2003 , to
Monique Simonetti
INRIA - Bureau des Relations Extérieures
BP 93 - 2004 route des Lucioles
06902 Sophia Antipolis Cedex
Tel : + 33 (0)4 92 38 78 64 Fax = + 33 (0)4 92 38 79 55
IDENTITY
Name First name
Affiliation
Address
City Zip code
Country
Phone Fax
Email

Registration fees
Academic 70 Euros Taxes included (58.53 Euros HT) Select your category
Industry 160 Euros Taxes included (133.78 Euros HT)
Student 40 Euros Taxes included (33.44 Euros HT)
Member of a telegeo team Your fees will be charged on ARC telegeo

The fees include two lunches, the coffee breaks and thursday diner.
Cancelation : Registration fees can be paid back on written demand to the above address before October 1st 2003

METHOD OF PAYMENT
- By "bon de commande (joint au bulletin d'inscription)" METHOD OF PAYMENT
- By "chèque bancaire en Euros
à l'ordre de l'Agent Comptable de l'INRIA"
- By bank transfert
to "Trésorerie Générale des Yvelines"
16 avenue de Saint Cloud
Accout n° 10071-78000-00003003958-80
Please specify your name and the conference name : Workshop on Geometry compression
- By credit card (VISA, EUROCARD or MASTERCARD)
by filling and signing the following form

Personal data : Last name First name
I authorize INRIA to charge my credit card
Card type Amount
Numéro Date d'expiration


Date Signature

NB 1: Data will be sent on the web using https. But if you do not want to send your card number on the web, even in secure mode, you can: 1- fill the card number and print 2- remove the card number 3- click the submit button. (you can also fill the card number on the printed form by hand).
NB 2: If the card holder is not the person which register to the workshop He must write (manually): I allow INRIA to charge my credit card for the inscription of Mr./Mme .....

TALK INFORMATION
Do you intend to give a talk ? Title

HOTEL INFORMATION
INRIA will book the hotel for you, but you will pay the hotel directly. It is not included in the registration fees.
Date of arrival
Date of departure
Type of room ?
If you ask for a double room, shared with :


To end your registration
1) Print
2) Fill your card number and sign (if you pay by credit card).
3) Click the submit button
4) (if you pay by credit card) Send the printed pages by fax or regular mail to above address
In case of problem, send an e-mail to Monique Simonetti or Olivier Devillers