Engineering
Conferences
International

info@eci.poly.edu

  
General Information and Fees
Final Call for Poster Abstracts

ASSOCIATION IN SOLUTION II
Structure, Function & Performance

July 26-30, 2009
Tomar, Portugal

ECI On-line Registration Form

This is an on-line form for registration information. (You must also fill out and fax or mail the Payment Form. Payment must be received at ECI by June 30, 2009.) To execute this form, fill in the boxes appropriately and click on the "Send Form to ECI" box at the bottom. You will be taken to a confirmation screen which displays the information sent to the ECI. You can print this confirmation screen to obtain a record of your registration. An email containing this information will also be sent to the email address you enter.
The entries marked with an * are required.
If an entry is required and not applicable, enter N/A or none.
If an email address is unavailable enter none@none

First Name*
Middle Initial (optional)
Last/Family/Sur Name *
Mr.   Ms.   Dr.   Prof.
Male   Female  Gender*
Nickname for Badge *
Organization / Institution / Company *
Street Address *
Street Address (2nd line, optional)
City *
State/Prov *
Postal Code *
Country *
Phone *
Fax *
E-Mail Address * (enter carefully only one address)

Email   Fax   Mail  Preferred Contact Method *

Arrival Date *   Departure Date *
The conference begins on July 26 and ends on July 30. If you wish to reserve accomodations for before or after the conference, see Fees and Registration.

Emergency Contact
Emergency Phone

Please select your accomodation. The default is Shared Room. Change, if not correct.

Register on or
before May 15		 Register after
May 15
Single Occupancy Room (no guest) US $1590.00 US $1690.00
Single Occupancy Room (guest, no meal plan)
(bed/breakfast cost of € 92 payable to the hotel)		 US $1590.00 US $1690.00
Participant (sharing a room with another participant) US $1465.00 US $1565.00
Bona fide Graduate Student (sharing a room with another student) (Those in this category must send proof of current status - copy of current Student ID can be faxed to 1-212-514-6030) US $1065.00 US $1165.00
Single Occupancy Room (guest, conference-included meals) US $2070.00 US $2170.00

Sharing Participant's Name, Otherwise Hotel Will Choose
Requests / Comments

If appropriate, please provide Guest name, Children's names and ages

Guest Fees
Guest Name See Above
Children's Names
Children's Ages		 Upon Request

Special Needs
Wheelchair Accessible   Vegetarian Meals   Food Allergy
Other (specify)

Select one of the options below to indicate form of payment.
The default is payment by credit card. Change, if not correct.
PAYMENT BY CREDIT CARD.
CHECK PAYABLE TO ENGINEERING CONFERENCES INTERNATIONAL AND DRAWN ON A        U.S. BANK IN U.S. DOLLARS IS BEING SENT.
DULY AUTHORIZED, SIGNED PURCHASE ORDER IS BEING SENT.
WIRE TRANSFER
        All bank fees -including those of ECI - must be paid by the sender.
        Please include an additional $30 to cover ECI bank fee if payment is made by wire transfer.
        Please contact the ECI office for bank information.
        Please reference your full name and the conference title.
        Fax a copy of your bank transfer papers to ECI (Fax: +1-212-514-6030).
        This is very important - otherwise it is extremely difficult to trace your payment.
CHECK OR PURCHASE ORDER IN PROCESS
        The ECI will accept this form of delayed payment provided
        that you give us the contact information below.
        An ECI representative will call this contact in order to confirm that payment is in process.
        Payment for my participation at the above conference has been initiated by:
         Contact's Name and Position
         Contact's Phone   Contact's Fax
         Contact's Organization

    

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