PSE'97/ESCAPE-7: Symposium registration form

Send a hardcopy of this form by fax or surface mail to
PSESCAPE-97 att Mrs. Tove Krokstad
Dept. of Chemical Engineering
Norwegian University of Science and Technology (NTNU)
N-7034 Trondheim, NORWAY
Fax: +47 7359 4080
Name (Surname, Given Name)
Preferred name on symposium badge:
Affiliation:
Mailing address:
City: Country:
Phone/Fax: Email:

SYMPOSIUM FEES (incl. proceedings, reception and closing drinks)
Before April 15 After April 15
Full rate, incl. banquet and lunches NOK 3.000 NOK 4.000
Full rate, excl banquet and lunches NOK 2.000 NOK 3.000
Student rate, incl banquet and lunches NOK 2.000 NOK 2.000
Student rate, excl banquet and lunches NOK 1.000 NOK 2.000
Banquet Dinner for accompanying person NOK 500 Name:
WORKSHOP FEES
Process Integration, 24 May NOK 1000
Process Operations, 25 May NOK 1000
TOTAL FEES PAID: NOK ________

METHOD OF PAYMENT Note: payment is required to confirm your registration

Credit Card VISA Euro/MasterCard Diners Club
Credit card number: _______________________ Exp.Date: ________
Name imprinted on card: _________________________________________
Date: ________ Signature: ___________________________________
Enclosed Check (payable to "PSESCAPE-97", only checks in NOK or US$ will be accepted)
Bank Transfer - enclose copy of receipt
To: PSE ESCAPE-97, Account no.: 8601.05.37772, Address: Fokus Bank, N-7005 Trondheim, Norway
THE WORKSHOPS

I wish to receive more information on the Workshop: Process Integration - Process Operations.
I wish to present a contribution to the Process Operations workshop and have sent an abstract to Prof. Bjarne Foss before April 1st.

pseadm@kjemi.unit.no
Last modified: Thu Feb 20 18:30:23 MET 1997