FYSICA - Register

Register

Register for FYSICA-CHEMIE 2012

Welcome to FYSICA-CHEMIE 2012. Please fill in the form below.

NNV and KNCV members pay 42,50 euro for attending FYSICA-CHEMIE 2012. Students and pensioners (who are members of the NNV or KNCV) pay only 17,50. All others pay 85 euros. If you register before 1 May, you get 5 euros discount. Additional dinner costs are 37,50 (17,50 for students and pensioners who are members of the NNV or KNCV). For dinner you also get a discount of 5 euros if you register before 1 May.

Personal information	Price information till 1 May 2012
Gender:	NNV-member	€ 37,50
Initials:	KNCV-member	€ 37,50
Family name:	Student/Retired members	€ 12,50
Email:	Non members	€ 80,00
Repeat email:	Dinner	€ 32,50
Membership NNV:	Dinner student/retired members	€ 12,50
Membership KNCV:
Student / Retired:
Focus session:

Address
Address:
Employer:		Department:
Street/PO:		House number:
Zipcode:		City:
Country:		Phone:

Other
Dinner:		Special diet:
Certificate:	Proof of attendance for students and teachers only.

Remarks
Remarks:

Conditions
Price:	€
Price dinner:	€
Your registration is not finalized until you have paid your registration fee. Please pay before May 7th, 2012. You can cancel your registration free of charge before May 1st or by transferring your registration to someone else. If you cancel your registration after May 1st cancellation fee of €10 will be charged for administration costs. If you cancel after May 15th your fee can't be refunded, but you can transfer your registration to your colleague. Please, let us know. PhD-students count as working (non-)members, so no reduction applies! The organisation can not be held responsible for damage to either the participants or goods during or as a result of participating in FYSICA-CHEMIE 2012.
I agree with the conditions above