ICCB 2017

Please type or write clearly in block letters and check boxes where appropriate and fax, post or email to:

Please provide information as you wish it to appear on your badge and in the list of participants (1).
"If these informations (First Name . Name . Company and Country) are not correct for establish the badge, please send an email."
Each participant should complete one copy of this registration form.
Please complete using a typewriter or block letters. Do not forget to make a copy for your own records.

( * ) Required field

Participant Information (1) ( use only alphabetic letters )

Title *: MrMrsDrProf

First Name *: Name *:

Nationality *: Position *:

Company/University *:

Research Department :

Address *:

Postal Code : City/State *:

Country *: E-mail *:

Phone (incl. country & city codes) : Fax (incl. country & city codes) :

Mobile :

Billing Address

Same as above

Company/University *:

Address *:

Postal Code *: City/State *:

Country *: E-mail :

Phone (incl. country & city codes) : Fax (incl. country & city codes) :

Registration fees ( TTC )

* Tick category and fill in the amount to be paid.
* To qualify for the fees below, every registrant shall provide proof of status on the registration form.

Before May 31st 2017 After May 31st 2017
Regular registration500 Euros550 Euros
Students registration350 Euros400 Euros
Conference banquet fee70 Euros70 Euros
ESB regular member400 Euros440 Euros
ESB student member280 Euros320 Euros
Sponsor Bronze1500 Euros1500 Euros
Sponsor Silver2000 Euros2000 Euros
Sponsor Gold2500 Euros2500 Euros
*Registration of one of the authors using FULL registration and associating the paper at the time of registration

Regular registration Students registration ESB regular member ESB student member Invited Sponsor Bronze Sponsor Silver Sponsor Gold
Conference banquet fee
Paper Id :

Registration fee includes : invited talks, lunches & coffee break, Proceedings, social event.
From 6 to 8 September 2017

Attendance to the meals :

lunch 6th September,2017
lunch 7th September,2017
lunch 8th September,2017
Gala dinner 7th September, 2017


Vegetalian
Vegetarian
Other :

Due ( TTC ) : Euros

Payment options

Payment must be made in advance and are payable to: UTEAM.
Please make sure that you indicate "ICCB 2017" and the participant's name on all payments.
Payment should be made in Euros.
Order forms has to be made to:

Credit card ( Only MasterCard, Visa and CB will be accepted. On-line registration is now opened )

Bank transfer
  Payable in Euros to the following account:
  Bank : Crédit du Nord Compiègne Entreprise
  Code bank : 30076
  Code counter : 02626
  Account Number : 10337100201
  Key : 47
  IBAN : FR7630076026261033710020147
  BIC : NORDFRPP
  SIRET : 34230024100029

Check (only in Euros) to UTEAM

Cash on the site (only in Euros)

CANCELLATION

For any cancellation, contact as soon as possible UTEAM by e-mail, fax or letter.
For a cancellation after July 24th, 2017 : 70 Euros will be charged for the administrative costs.
After this date, no refund is possible
It is impossible to cancel a registration if your paper is accepted by the comittee

This information is intended for the organizers UTeam or ICCB 2017 in the purpose of setting down the list of the participants.
You may oppose to the publication of your email address in the list of participants by ticking here
You have a right of access and modification by applying to UTeam until 8th September 2017.