IO2015 - XVII APDIO Congress

Instituto Politécnico de Portalegre

IO2015 - XVII APDIO Congress
Registration Form:

07-09 september-2015

Identification

Full Name:

Address:

Post Code:

Telephone:

E-mail:

Affiliation

Institution/Organization:

Address:

Post Code:

Telephone:

E-mail:

APDIO member? Student-EstudIO? Accompanying person?
Please select your situation in the box below:

Ammount:

Participant Type	Reduced Price	Price
Member of APDIO (1)	290€	340€
Non-member of APDIO (2)	340€	390€
Student-EstudIO	100€	190€
Students	160€	190€
Accompanying person	115€	115€
Children under 12 years old	55€	55€

(1) IPP staff, Members of APDIO: lunches/coffees, documentation/certificate, and 2015’s membership fee for APDIO members.

(2) Non-members: lunches/coffees, documentation/certificate, and the fees for member registration and the 2015’s yearly fee are included.

Denomination for Receipt:

Identification Tax Number:

Bank Payment Reference:

IF APDIO member, please indicate number/reference:

Accommodation at IPP Students’ Residence? (15€/night)

Please indicate the accommodation night(s):

Registration and Payment:

- Registration and payment services provided by IPP Central Services;

- The confirmation of registration occurs after the reception of payment;

- The registration may be cancelled by the participant and the amount (minus administration costs) reimbursed if and only if the cancellation occurs until thirty days (30) before the event;

Payment by bank transfer:

ACCOUNT NAME: INSTIT.POLITÉC.PORTAL-RECEITAS PRÓPRIAS
NIB: 078101120000000440451
IBAN:PT50078101120000000440451
BIC:IGCPPTPL
SWIFT BIC CODE:IGCPPTP1
NIF:600 028 348

(Please send the ATM or the bank transfer receipt to cpsd@estgp.pt

Contacts for registration:

Instituto Politécnico de Portalegre
Escola Superior de Tecnologia e Gestão
Cristina Dias
cpsd@estgp.pt
Lugar da Abadessa, Apt. 148
7301-901 Portalegre
Portugal
Tel: + 351 245 300 200 / + 351 245 300 255
Fax: + 351 245 300 230