Registration form

REGISTRATION FORM

12th INTERNATIONAL CONFERENCE ON FERROELECTRIC LIQUID CRYSTALS “New Challenges on Chiral and Polar Systems” August 31 – September 4 2009 Zaragoza (SPAIN)

Viajes el Corte Ingles - Events Department
C/ Camon Aznar nº 5. - 50004 Saragossa, Spain
Phone nber : 0034 976 46 96 28. Fax nber: 0034 976 28 24 50
E-mail: congresos_zaz@viajeseci.es

PERSONAL DETAILS

*Family Name :**
*First Name :**
*Title (Dr...) :**
*Passport Number :**
*Affiliation :**
Postal Address:
Zip Code:
*City :**
Province :
*Country :**
*Phone Number :**
Fax Number:
Mobile Number:
*Email :**
Verify E-mail:
Fields with * are mandatory

REGISTRATION FEES

	Early registration, before 31 May, 2009	From 01 June, 2009 or On-site registration
Regular Participants	320 €	420 €
Students	150 €	200 €
Tutorial	25 €	35 €

Students will have to provide a copy of their student identity card or any official document from the Institution that probe the student

General registration: Conference documentation, access to the sessions, coffee breaks, welcome party and one day (24 h) Zaragoza Card

Tutorials: Including documentation and access to the sessions

ACTIVITIES:

	CONFERENCE BANQUET [I'm vegetarian ] (3rd September)	50 €
	CITY TOUR (1st September)	23 €
	MONASTERIO DE PIEDRA NATURAL PARK (2nd September)	50 €
	MONASTERIO DE PIEDRA NATURAL PARK (5th September)	50 €
	MONASTERIO SAN JUAN DE LA PEÑA (5th September)	46 €

ACCOMPANYING PERSON

Accompanying Person	50 € Early registration, before 31 May, 2009 [55 € From 1 june 2009 or On-site registration]
Family Name:
First Name:
Passport Number:

ACCOMPANYING ACTIVITIES:

	CONFERENCE BANQUET [I'm vegetarian ] (3rd September)	50 €
	CITY TOUR (1st September)	23 €
	MONASTERIO DE PIEDRA NATURAL PARK (2nd September)	50 €
	MONASTERIO DE PIEDRA NATURAL PARK (5th September)	50 €
	MONASTERIO SAN JUAN DE LA PEÑA (5th September)	46 €

Total to pay:

REGISTRATION FEES:	€
ACTIVITIES:	€
ACCOMPANYING PERSON:	€
TOTAL:	€

FORM OF PAYMENT: BANK TRANSFER

From Spain:
Bank Transfer (free of charges) to:
VIAJES EL CORTE INGLES
Bank: Banco Santander Central Hispano
Account Number: 0049 1500 03 2810355229

From Abroad:
Bank Transfer (free of charges) to:
VIAJES EL CORTE INGLES
Bank: Banco Bilbao Vizcaya Argentaria
IBAN ES970182 3999 3702 0066 4662
BIC: BBVAESMMXXX

COPY OF THE BANK TRANSFER MUST BE SENT BY FAX AT THE FOLLOWING NUMBER: 0034 976 282 450
ONLY REGISTRATION FORMS WITH FULL PAYMENT WILL BE CONSIDERED BY THE SECRETARIAT

Please feel in the following form to get an invoice::

Company Name:
Fiscal Tax Number:
Postal Address:
City:
Zip code:
Province:
Country:
Contact person:

“The personal details included in this document are of a confidential nature. In accordance with the Organic Law 15/1999, of 13 December, the holder of this data will be able to exercise his or her right of access, rectification and cancellation on written application to Viajes El Corte Inglés, S. A"

CANCELLATION POLICY
If you need to cancel your registration; written notification for your cancellation of registration must be reported to congresos_zaz@viajeseci.es
We consider the day we receive your notice is the day of your cancellation.
Cancellation charges are as follows:
Before 30 July, 2009: 20% (80% of total shall be refunded).
After 31 July, 2009: 100% (no refund can be made).