REGISTRATION FORM FOR LEARNING'00

To be faxed to: Learning'00 Secretariat, Fax: +341 624 9430

Full Name:   ______________________________________________________
Affiliation:     ______________________________________________________
Full Address:______________________________________________________
                    ______________________________________________________
E-mail:          __________________ Ph.:  _____________ Fax:  _____________

REGISTRATION  FEES
             -  General fee                                 50,000 pta. (300,51 Euros) (or US$ 2861)
             -  Full-time univesity teachers fee    35,000 pta. (210,35 Euros) (or US$ 2001)
             -  Student fee                                 15,000 pta. (  90,15 Euros) (or US$   861)              -  General fee                                 75,000 pta. (450,76 Euros) (or US$ 4291)
             -  Full-time univesity teachers fee    50,000 pta. (300,51 Euros) (or US$ 2001)
             -  Student fee                                 25,000 pta. (150,25 Euros) (or US$ 1431)

    EXCURSION TO SEGOVIA AND OFFICIAL DINNER
    (Scheduled on thursday 26th are not included in the registration fee)

             - Excursion and Official Dinner         7,000 ptas (42,07 Euros) (or US$   401)
 
    NOTE: Students must fax the appropriate accreditation along with this registration form.
 
    (1) Subject to variations of the currency exchange rate

PAYMENT (tick as appropriate)

   __ Bank transfer to
      LEARNING
      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 a receipt? __YES __NO