M I S 2005

    WORKSHOP ON MULTIMEDIA INFORMATION SYSTEMS

    Sorrento – Hotel Parco dei Principi - September 19-21 2005

    R E G I S T R A T I ON F O R M

Please complete and return (by fax) this form to:

    Mis 2005 Scientific Secretariat – DELOS Congressi

    Fax: +39 081 2403299

The registration process is handled by DELOS Congressi

    http://www.deloscongressi.it e-mail: delosnapoli@tin.it

    Tel: +39 081 2403199 Fax: +39 081 2403299

    Please complete this section accurately; the information you provide will allow us to correspond with you efficiently and will also be used for your badge at the Workshop.

Title ........................ First name ....................................... Family name.......................................................

    Affiliation:................................................................................................................................................................... Address: [] home [] office........................................................................................................................................... Fax number .................................................... Telephone number ...................................

    E-mail ....................................................

    Accompanying person (please indicate the name): …………………………...........................................................

    REGISTRATION FEES

    Registrant

    • Payment received before JULY 30 Euro 350

    • Payment received after JULY 30 Euro 400

Accompanying person:

    • Payment received before JULY 30: Euro 250

    • Payment received after JULY 30: Euro 300

    Registration fees include admission to the workshop, proceedings, official programme events, workshop package, social events, coffee breaks and working lunches during the workshop.

Cancellation

    Cancellation must be received in writing by the Workshop Scientific Secretariat. In case of cancellation, by September 1 2005, full refunds, less 16 Euro processing fee per registrant, will be guaranteed. After September 1 2005, no refunds will be

    possible. All refunds will be handled after the Workshop.

Payment

    CREDIT CARDS

    Mastercard [] Visa []

    Expiration date........................................................ Card Number.....................................................................

    Card Holder Name........................................ ............... Signature.....................................................................

    I, the undersigned, certify that I have read and hereby accept the conditions of registration and cancellation as

    stated in this registration form.

    Signature......................................................................................... Date....................................................