ICDHS 2010 BOOKING FORM

TITLE

EMAIL

FIRSTNAME

SURNAME

ADDRESS + NR.

POSTAL CODE

CITY

COUNTRY

PHONE

FAX

DEPT. / INSTITUTION

DELEGATE LISTING – Please check to confirm your agreement to the inclusion of your title, name, institutional affiliation and email address, as above, in the delegate listing for the conference pack.

Please check to confirm your agreement to the ICDHS maintaining your details in order to notify you of future events.

Please check to confirm you require a receipt (this will be in the conference pack handed out at registration)

TOTAL AMOUNT PAYABLE : 

3. CONFERENCE VISITS  All visits include transport to and from the conference site. Limited places available. Confirmation will be sent.
Payment on the day of the tour, before departure. Lunch is not included. Please select an option.

Please check to confirm payment by invoice

Please note that full refunds on delegate fee will be available up to 30th June. Any requests for refunds received after the 1st July, will only receive 50% return of the fee.

BANK TRANSFER INFROMATION 

Bank Name: KBC
Branch Name: Bedrijvenkantoor Leuven
Bank Address: Brusselsesteenweg 100
3000 Leuven
Belgium

Account number: 432-0000011-57
IBAN account number: BE09 4320 0000 1157
BIC/SWIFT code: KREDBEBB
Please quote 400/0004/19563 on your payment.

Account holder: K.U.Leuven
Address: Krakenstraat 3
3000 LEUVEN
Belgium

Please make your payment simultaneously with your registration and transfer a sum according to your bookings to the KULeuven account. Neither personal cheque nor credit card are acceptable. It is very important that you quote 400/0004/19563 on the bank transfer. If several fees are to be sent together, please make sure that the names of every participant are clearly indicated. We will be happy to confirm by e-mail when both registration form and fees reach us.

As you might have noticed, registration fees have been kept to a minimum to facilitate attendance. Therefore, please be sure of paying all necessary handling charges specifying "beneficiary charge" when ordering your transfer. Terms such as "beneficiary charge" might differ with countries or banks. Therefore, it is safer to ask your bank that all handling charges should be paid by yourself.