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Registration + pay form - Summerschool Functional Coatings

Universiteit Hasselt - Knowledge in action

REGISTRATION + PAY FORM - SUMMERSCHOOL FUNCTIONAL COATINGS

 
Identification
•  Gender*:
 Male   -    Female
•  First name*:
•  Last name*:
•  Highest degree*:
  e.g. master, PhD, ...
•  Organization / University*:
◦  Street*:
nr*: bus :
◦  Postal code*:
◦  City*:
◦  State :
◦  Country*:
◦  E-mail*:

Don't enter more than 1 e-mail address. You will shortly receive
a confirmation e-mail, also check your spam folder.
◦  Phone :
◦  Fax :
Registration*

•  Student (master of PhD) Registration
There are only a limited number of spots available for students.
 I am a student from UHasselt (no fee)
 I am a student from University College Kaiserslautern (no fee – hostel included from Sunday until Friday – shared rooms of 4 to 6 persons)
 I am a student from another university (college) (€ 249 – hostel included from Sunday until Friday – shared rooms of 4 to 6 persons)*
•  Industrial Registration
 Full Registration: Includes access to all academic sessions – lectures, lab-day and lab-tour and social activity on Thursday evening (€ 299) [No registration for rooms included]
 Partial Registration: Includes access to all academic sessions without lab-day and lab-tour and social activity (€199)

Questions and/or remarks
If you should have any questions and/or remarks, you can post them here:


Payment
•  Total amount to be paid :   euro.
•  Invoice required*:
 No
 Yes
•  Payment method*:
 Online Payment  
 Bank transfer  
 No payment (student of UHasselt or University College Kaiserslautern)  

*mandatory fields