REGISTRATION FORM

Please fill out this form in block letters and send it back to the WCERE 2010 Secretariat prior to April 30, 2010 in order to benefit from

Pre-registration fees. All fees indicated below are in Canadian dollars (CAD) and include applicable provincial and federal taxes.

Mr. Ms. Mrs. Dr. / If you are a presenting author enter your Participant IDENT Number:______
and Paper Submission Number:______
First Name: / Family Name:
Position: / Organization:
Postal Address:
City: / State/Province:
Zip/Postal Code: / Country:
Tel: / Fax:
E-Mail:
REGISTRATION CATEGORIES
/
Before April 30, 2010
/
After April 30, 2010
q / Member Registration1,4 / $705 CAD / $825 CAD
q / Member Reduced Fee Registration1,2,4 / $525 CAD / $609 CAD
q / Non-Member Registration1,5 / $904 CAD / $1024 CAD
q / Non-Member Reduced Fee Registration1,2,5 / $583 CAD / $667 CAD
q / Accompanying Person3 / $225 CAD / $249 CAD
First Name:
Last Name:
1 Includes access to all sessions, the coffee-breaks, lunches, the welcome reception and all social activities.
2 To view the categories of registrants entitled to the reduced registration fee, click here.
3 Includes access to the welcome reception and all social activities. Please provide person’s name.
4 Member's rates are available to all 2010 active members of either the AERE or the EAERE.
5 The sum of the AERE or EAERE membership fee and the member registration fee is much less than the non-member registration fee. We encourage you to become a member before registering.
TOTAL PAYMENT
Please total the amounts of Registration Category and add $25 if paid by bank transfer:
Total :
/ /
Bank Transfer (25$)
/
+
/
Total:
/ /
PAYMENT INFORMATION
/ q
/ q
q / Expiry date: / ______/ ______
Bank transfert / q / Signature:
Check* / q / Card holder name:

Bureau des Congrès Universitaires – WCERE 2010 Secretariat

162, Place Gatine St-Jerome QC J7Y 5K3 Canada

Telephone +1 514-340-3215 – Fax: +1 514-340-4440 – E-mail: