Registration Form

26-27 January 2017, ISEG; Lisbon

Please complete and return this form to:

1)  Email:

2)  Address: UECE, ISEG/ULisboa

Rua Miguel Lupi, 20

1249-078 Lisboa, Portugal

Contact Details

First Name
Surname
Institution
E-mail
Phone

Workshop Registration (Registration fee is per person and includes the attendance at the Workshop and Workshop materials. Lunches and coffee breaks will be provided by the organizers to the registered participants.)

Before December 18th / After December 18th
Regular participant / 200 € / 250 €
Student* / 100€ / 150€

* Students must send a proof confirming their status.

Dietary requirements (For catering purposes at the workshop, please indicate if you have special dietary requirements.)

No Yes If yes, please specify ______

Workshop Dinner with Fado Music (The workshop dinner is not included. If you wish to register for dinner at 55€ per person, please indicate below.):

Number of tickets

Name Badge (Please indicate the contact details for your name badge at the workshop. If different from above.)

First Name
Surname
Institution

PAYMENT

Payment Summary

Registration / ______Euros
Workshop dinner / ______Euros
TOTAL / ______Euros

Payment Method

You can pay using PayPal by making a wire transfer or by cheque.

PayPal

More details at http://cemapre.iseg.ulisboa.pt/educonf/4e3/registration.php

Transfers from bank accounts

Receiver Name:UECE- Unidade de Estudos sobre a Complexidade e Economia

Receiver Address: Rua Miguel Lupi, 20, 1249-078 Lisboa, Portugal

Bank: Caixa Geral de Depósitos

Bank Address: ISEG-Rua do Quelhas, 6 1200-083 Lisboa, Portugal

NIB: 003 503 710 000 408 263 002

IBAN: PT50003503710000408263002

SWIFT: CGDIPTPL

Cheque

A cheque in Euros made payable to UECE and accompanied by the full details of the participant should be posted to the following address:

UECE, ISEG/ULisboa

Rua Miguel Lupi, 20

1249-078 Lisboa, Portugal

Important:

Please make sure that the transfer includes a reference to the name of the participant.

Alternatively, you can send a copy of the order to UECE by e-mail or a bank e-mail.

Possible bank charges will be supported by the payer