ATALANTE 2004
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Registration form
If you don't register online, download the Registration form.pdf

(* = required)

Informations collected above are aimed to help the Atalante 2004 Local Organizing Committee to compile a data file of the participants to the conference. These informations will not be communicated to any other organization. According to the French law "Informatique et LibertÚs" (art. 34), you have a right of access, modification, and removal of your data. For this purpose, you can contact the Local Organizing Committee of the conference.

Participant - one form per participant
Mr *
Ms
Title
Last Name (Nom de famille)*
First Name *
Affiliation/company *
Affiliation address *
City *
Postal Code *
Country *
Phone * (e.g.: +33 4 66796347)
Fax number * (e.g.: +33 4 66796347)
e-mail *

I will attend
Welcome cocktail on Sunday 20 June *
yes
no
Cocktail on Monday 21 June *
yes
no
Entertainment evening and dinner on Wednesday 23 June *
yes
no

TECHNICAL VISITS
(Book no later than 31 May 2004)
Visits will be accepted after authorities agreement and according to availability

Information to fill out only for technical visits
Valid passport (or idendity card for EU visitors
Date of birth (day/month/19xx)
Place of birth
Nationality
Passport or identity card number
Home address
I will visit on Friday, 25 June (included in registration fees). Chose Marcoule or Cadarache
Marcoule: chose only one facility
ATALANTE
PHENIX
MELOX
CENTRACO
Cadarache
both LECA and LEFCA

REGISTRATION FEES in Euros, VAT included
We encourage early registration! Those who register by 15 May are automatically entered in a drawing for the Entertainment evening.

Every participant for any day of the conference *
Early, before 15 May 2004: 450 euros
Late, after 15 May 2004: 550 euros
Student: 100 euros
Accompanying person(s): additional entertainment evening and dinner on 23 June: 60 euros
Your registration covers attendance at 4 days of confrerences and access to posters, coffee breaks, all lunches, the welcome cocktail on 20 June, the entertainment evening and dinner on 23 June, technical visits

Payment
In euros only made out to the CEA VALRHO:

(Indicate your name with the payment)
By cheque
By transfer

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