LES BENELUX TOPIC MEETING
REGISTRATION FORM

I will attend the upcoming LES Benelux Topic Meeting on
Date:
I will:

 
Fees include coffee and tea in the breaks, lunch and drinks after the meeting.

Remittance must be at least 14 days in advance to:
KBC in Ghent, Belgium (BIC KREDBEBB),
account 730-1406738-40 (IBAN BE02730140673840)
or to:
ABN-AMRO in Wijk bij Duurstede, The Netherlands (BIC ABNANL2A),
account 40.80.04.738 (IBAN NL72ABNA0408004738)

Please note that cheques will not be accepted, but at the meeting payment can be made by credit card (AMEX, Visa and Eurocard).

By completing and sending this electronic registration form I know and agree that cancellations must be received at least 7 days before the meeting takes place in order not to be charged for the full meeting costs.

Name:
Company:
Address:
Phone:
Fax:
E-mail:
LES:

Forthcoming Meetings