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CENSTAT


CENSTAT

Universiteit Hasselt - Knowledge in action

REGISTRATION FORM

 
  Title : Prof. Dr. Mr. Mrs.(*)
  First name : (*)
  Last name : (*)
  E-mail : (*)
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  Organization/Institute : (*)
 Address line 1 :
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 Address line 2 :
 Postal/Zip code:
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 City:
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  I would like to participate in following parts of the course: (*)
Students/Non-profit sectorProfit sector
days 1-3 € 450
days 4-5 € 350
days 1-5 € 600
days 1-3 € 700
days 4-5 € 600
days 1-5 € 900
 Dietary request:
 

 Social event (walk and dinner, 8 september) € 55. (*)
  I will attend the social event.
  I will not attend the social event.

  I would like to purchase the book by Hens et al. (2012) (€ 60):
Yes   No   (*)

  Invoice:(*)
  I need an invoice.
VAT number organization/institute: 
 
  Payment method : Bank transfer   Online Payment   (*)


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