ICML '96
13th International Conference on Machine Learning
July 3 - 6, 1996 - Bari (Italy)
CONFERENCE REGISTRATION FORM
Please return this form along with the deposit to:
CENTRO INTERNAZIONALE CONGRESSI,
II Trav. Via S. Matarrese, 3 - 70124 Bari, Italy
Telephone Number: (+39) 80-5617299, Fax Number: (+39) 80-5614533
Please type or print clearly
Name:_________________________________________________________________________
Last First Title (M/F)
Institution or Company: ____________________________________________________
Address: ________________________________________________________________
_________________________________________________________________
City Post Code Country
Telephone No: ___________________________ Fax No:_________________________
E-mail:______________________________________
REGISTRATION FEES (All Amounts Include Vat)
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CONFERENCE
By May 24, 1996 After May 24, 1996
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Regular Registrant Lit. 420.000 Lit. 520.000 |Lit. ________ |
Student * Lit. 120.000 Lit. 150.000 |Lit. ________ |
AI*IA Member (regular) Lit. 370.000 Lit. 470.000 |Lit. ________ |
AI*IA Member (student) Lit. 100.000 Lit. 120.000 |Lit. ________ |
COLT-96 registrant (regular) Lit. 370.000 Lit. 470.000 |Lit. ________ |
COLT-96 registrant (student) Lit. 100.000 Lit. 120.000 |Lit. ________ |
WORKSHOPS
W 1 W 2 W 3 W 4 W 5 Lit. 15.000 per workshop notes |Lit. ___________ |
Total amount Lit. ________________
*Students must enclose a document certifying their status.
I am sending the payment in Italian Lire for the amount of
Lit.__________________ payable to Centro Internazionale Congressi s.r.l.
Method of payment
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|_| Foreign draft/eurocheques payable to:
Centro Internazionale Congressi s.r.l.
|_| Bank transfer to: Centro Internazionale Congressi - Account no: 27/995 -
Banco di Napoli Ag. 6 - Via Giovanni XXIII 70124 Bari, Italy.
(cod. ABI 1010 - cod. CAB 04006)
Please enclose a copy of the bank transfer payment with your registration
form.
|_| Credit Card
|_| VISA |_| EUROCARD / MASTERCARD |_| DINERS' CLUB
Card No. |_ |_ |_ |_ |_ | _| _|_ | _|_ |_ |_ |_ |_ |_ |_ |
Expiration date | _| _|/| _| _|
Cardholder's name (please print)__________________ Signature______________
SETTLEMENT
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Please make the amount payable in Italian lira to: Centro Internazionale
Congressi s.r.l. and send it to the Organizing Secretariat. Registration
cannot be confirmed if the present form is not accompanied by the
corresponding payment.
The bank charges must be added to the above amount. Any difference will be
settled locally.
In case a cancellation becomes necessary, it should be notified to the
organising secretariat in writing. The following refund policy will be
observed:
Cancellation of your participation before May 24, 1996: refund of paied
amount, less Lit. 50.000
Cancellation by June 24, 1996: 50% refund
Cancellation after this date: no refund.
All refunds will be forwarded after the Conference.
I have duly read the registration and cancellation regulations and accept
the conditions.
Date: ___________________ Signature: ______________________________________