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TOTeMs Registration

By filling in the form below you may confirm your participation to the TOTeM(s) 19 or 20 to be held at the "Akersloot Hotel", on 11th - 12th June 2002.
The under named confirms his/her participation in the TOTeMs to be held at the "Akersloot Hotel", on 11th - 12th June 2002, and agrees to pay the amount (please tick as appropriate):
  • €500 to attend both TOTeMs
  • €275 to attend TOTeM19 only
  • €275 to attend TOTeM20 only

Payment should be made according to the instructions in the "payment" section of the announcement.

The under named will attend:

The TOTeM19 sessions on 11th June
The Social Gathering on the evening of 11th June
The TOTeM20 sessions on 12th June
  Yes No;
Yes No;
Yes No.

Further Requirements:

Complete also the communication data form below. On receipt of the registration form, confirmations and invoices will be sent. Receipts will be available upon registration.

Communication data
(Essential fields in bold)

Personal Data

Title: (Prof., Dr., Mr., others)
Initials:
First Name:
Family Name:

 Organisation Data

Company/Institute:
Division:

 Telecom Data

Tel. No. (direct):
Telefax No.:

Internet Addresses

E-Mail:
WWW site (URL):

 Mailing Address

P.O. Box No. / Street+No.:
Town / Code:
Country:

Hotel Booking

Do not forget that you must book your hotel room independently. For hotel registration, please use the registration form (download PDF, 88Kb).

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