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REGISTRATION FORM FOR LEARNING'98
To be faxed to:
Learning'98 Secretariat, Fax: +341 624 9430
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Full Name: ______________________________________________________
Affiliation: ______________________________________________________
Full Address:______________________________________________________
______________________________________________________
E-mail: ______________ Ph.: _____________ Fax: _____________
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REGISTRATION FEES
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* Until July 31st:
- General fee 38,000 pta. (or US$ 250)
- Student fee 10,000 pta. (or US$ 65)
* After July 31st:
- General fee 45,000 pta. (or US$ 300)
- Student fee 12,000 pta. (or US$ 80)
NOTE: Students must fax the appropriate accreditation along with
this registration form.
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PAYMENT (tick as appropriate)
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__ Bank transfer to
LEARNING'98
La Caixa - Avda.de Abrantes
Carrero Juan Ramon, 1 - 28025 Madrid
Account no.: 2100 2929 85 020000 2945
(please, notify us of your transfer by e-mail)
__ Credit Card
__Master Card __VISA __AMEX
Card Number: _______________________ Exp. date:____________
Cardholder's name: _________________________________________
Cardholder's signature: ____________________________________
(mandatory)
Do you need an invoice? __YES __NO