REGISTRATION FORM
for the Belgian-French Workshop on Optical Methods
Tuesday June 17, 2003

Please fill and return before 13th June 2003 to the secretary below

 

Title First name Surname

 

Company Department


 

Address

 

Tel

 

Address

 

Fax

 

Postal code City Country

 

E-mail

I will attend the Belgian-French Workshop on Optical Methods on June 17, 2003
The registration fee (includes coffee breaks and lunch + abstract booklet):

80
60 for members of the organising and supporting societies: BSMEE, AFM, Promoptica, Cmoi
free - Students (does not include lunch)

Payment:
by bank transfer to 432-0000381-39 (K.U.Leuven, Department MTM, Kasteelpark Arenberg 44, 3001 Heverlee)
please mention 'Belgian-French Workshop on Optical Methods' on bank transfert.
cash at the welcome desk

Signature:

 

 

Date:

 

 

PLEASE FAX OR E-MAIL THIS FORM TO
Katrien Baplu (secretary)
fax: +32 16 321990

e-mail: Katrien.Baplu@mtm.kuleuven.ac.be
Department MTM, Katholieke Universiteit Leuven
Kasteelpark Arenberg 44
3001 Leuven (Heverlee)
tel. +32 16 321300