| FAX to: | Franziska Gusel +43 1 5880118597. | |
|---|---|---|
| Personal Information | ||
| Name (for name tag) | ||
| Affiliation | ||
| Postal address |
| |
| Email address | ||
| Registration Choice | ||
| Fill in the amount for only one option | ||
|
Regular early registration (by 7th November) | EU425 | |
| Regular late registration | EU500 | |
|
Student early registration (Lower fee thanks to Microsoft) | EU300 | |
| Student late registration | EU350 | |
| ESHOL only registration | EU100 | |
| Students must include a copy of their student card in the FAX. | ||
| Payment | ||
| Credit card type | Visa or MasterCard: | |
| Credit card number | ||
| Expiry date | ||
| Name on card | ||
| Signature |
| |
| Date | ||