ΕΘΝΙΚΟ ΜΕΤΣΟΒΙΟ ΠΟΛΥΤΕΧΝΕΙΟ

NATIONAL TECHNICALUNIVERSITY OF ATHENS

 

 

 

Registration Form

Last Name First Name Title

Company

 
Street
Postal Code City Country
Phone Fax E-mail

Member of which organisation/association(s)













Registration and payment received:      before 1st Oct.02     after 1st Oct. 02
Student    € 50,-     € 75,-

Other participant  

  €130,-     € 180,-

Prices are per person. VAT at 18% is already included.

1) Please submit one form per delegate
2) Students should present one of the following:
a valid student ID or a letter from their supervisor,
   
or a certificate from their Department.
3) The fees include workshop documentation, coffees, lunches and the workshop dinner

Payment by bank transfer:
I have ordered a bank transfer (Please send by mail or e-mail a copy of the bank transfer order)

Bank name: NATIONAL BANK OF GREECE
Address: 38, STADIOU STR. 10564 ATHENS
Account number: 080/300079-60         Ref. "CEAS/ASC Workshop"
IBAN: GR18 0110 0801 0000 0803 0007 960

Banking fees have to be settled by the remitter. You should mention your name and the reference code
"CEAS/ASC Workshop" so that the money can be assigned to your account

Credit card :
Please charge the amount of EURO to my credit card:
VISA                   MASTER CARD  
Card Number:        Expiry Date:
Cardholder's Name:  
Date:   Place:   Signature:_______________

NOTE: Please send this form signed by fax, adding a photocopy of your passport and of your credit card|
          
(both sides)