GAMEON-NA'2007 Registration Form

(Or use the fax reply form)

Please note: This form does NOT work with Internet Explorer 3.02 or lower. It does work fine with all versions of Netscape and higher versions of Explorer.

If e-mail fails, you can also print this information and send / fax it to:
Philippe Geril, EUROSIS-ETI,
European Simulation Office
Ghent University,
Faculty of Engineering, Dept.of Industrial Management,
Technologiepark 903 , B-9052, Zwijnaarde-Ghent, Belgium.
Phone: +32-9-264.55.09, Fax: +32-9-264.58.25

Personal Information

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user email

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AUGUST-30-by-BANK-TRANSFER-to-account-No.-001-4081477-84--European-Technology-Institute,-ETI-Bvba,-FORTIS-BANK,-Branch-Office-Ghent-Centre,-Zonnestraat-2,-B-9000-Ghent,-Belgium-IBAN-CODE:-BE03-0014-0814-7784,-SWIFT-CODE:-GEBABEBB-:-001-4081477-84-MENTION-YOUR-NAME-and-GAMEON-NA-2007-(make-a-print-of-this-form-so-you-know-what-you-submitted)-and-ADD-A-COPY-OF-PAYMENT-TO-THIS-FORM-wrapper"> I will make payment before AUGUST 30 by BANK TRANSFER to account No. 001-4081477-84 European Technology Institute, ETI Bvba, FORTIS BANK, Branch Office Ghent Centre, Zonnestraat 2, B-9000 Ghent, Belgium IBAN CODE: BE03 0014 0814 7784, SWIFT CODE: GEBABEBB : 001-4081477-84 MENTION YOUR NAME and GAMEON-NA 2007 (make a print of this form so you know what you submitted) and ADD A COPY OF PAYMENT TO THIS FORM

I will pay by CHEQUE before AUGUST 30 and send it to Philippe Geril, EUROSIS-ETI, European Simulation Office, Ghent University, Faculty of Engineering, Dept.of Industrial Management, Technologiepark 903 , B-9052, Zwijnaarde-Ghent, Belgium. (make a print of this form so you know what you submitted)

I will pay by CREDIT CARD but do not send the information with the form. Please phone me for the credit card information

I will pay by CREDIT CARD and fill in the information below.

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GAMEON-NA'2007 Registration Form

(Or use the fax reply form)

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