PLEASE NOTE: Inordertofacilitatenetworkingamongstdelegates,Yournameandcoordinates

Code

FaxcompletedRegistrationFormto

(+4021)318-8894; (+4021) 318-8876

CONFERENCE SECRETARIAT
CEPROCIM S.A.
#6, Preciziei Blvd.
Sector 6, Postal code 062203
Bucharest, ROMANIA
/
The SecondInternational Proficiency Testing Conference
Sibiu, România
(15)16th − 18th September, 2009

A. GENERALINFORMATIONPLEASETYPEORPRINTCLEARLYMs. Mrs. Mr. Dr. Prof.

Family name: / First name:
Title/ Position:
Affiliation:
Mailing address:
City: / State, if appropriate:
Country: / Postal code:
Phone (+area code – number): / Fax (+area code – number):
E-mail address: / Web site:

PLEASE NOTE: Inordertofacilitatenetworkingamongstdelegates,yournameandcoordinates willappearonthe PT-CONF2009ParticipantList.

B. REGISTRATIONFEES

Early registration –Late registration –

Before 1st July, 2009After 1st July, 2009

 Participant / 300EUR / 350EUR / EUR
 Studentand PhD students* / 130EUR / 150EUR / EUR
 Training Course Statistics in PT - From homogeneity and stability testing to consensus means and proficiency assessment / 65EUR / 75EUR / EUR
 Excursion: Sighisoara / 50EUR / 60EUR / EUR

University/ Faculty/ Department: ______StudentIDNo: ______

The participants at the Training Course “Statistics in PT - From homogeneity and stability testing to consensus means and proficiency assessment” will receive the course documents and the diploma of participation.

C. METHODOFPAYMENT

IhavenotedthetermsandconditionsdetailedintheRegistrationInformationand
accordinglymakepaymentforregistrationtothePT-CONF2009Conference. / Total Remittance : EUR ______

PAYMENT BY CREDITCARD

Pleasechargethetotalamountabovetothefollowingcreditcard:VISAMasterCard

Name(asitappearsoncard): ExpiryDate : MONTH /YEAR:

CardNumber : - - - Signature : _

PAYMENT BY BANK TRANSFER must be made to the following bank accounts:

In EURO

Account name / Association of Proficiency Testing Scheme Providers AFSIC
Bank / Banca Româna pentru Dezvoltare – Groupe Société Générale, Unity: Militari
Address: Iuliu Maniu Boulevard no. 111, Sector 6, Postal code 061097,
Bucharest, Romania
IBAN number / RO37BRDE410SV35339084100
Swift code / BRDEROBU
Refund of the registration fee is only possible when a written cancellation of registration reaches the Conference Secretariat before 1st August, 2009. In that case,there
will be an 80% refund. After this date, the registration fees are non-refundable.- REGISTRATIONWILLBECONFIRMEDBYMAIL,FAXORE-MAIL
TEL:+40-21-318-8893 / FAX:+40-21-318-8894; +40-21-318-8876 / EMAIL: /WEB:

In LEI

Important things about the bank transfer

1. Please remember to indicate your full name as the issuer of the transference and the purpose of payment

Registration fee for PT-CONF in the message field on the remittance application. Please be sure to pay all fees

charged from your bank. We must receive your bank transfer amount in full.

2. Please do not forget to send us by e-mail or by fax a copy of your bank remittance receipt.

Fill here its number ...... and its date ......

D.ACCOMMODATIONPlease check a hotel and the room type.

Check-in Check-outNumber of nights

IBISHOTEL / RAMADA HOTEL / SILVA HOTEL / PARCHOTEL
Room Type / Price/ day / Room Type / Price/ day / Room Type / Price/ day / Room Type / Price/ day
lei / euro / lei / euro / lei / euro / lei / euro
Single room  / 201 / 56 / Single room  / - / 97 / Single room  / 190 / 53 / Single room  / 200 / 56
Double room  / 237 / 66 / Double room  / - / 118 / Double room  / 245 / 68 / Double room  / 250 / 70

* Just in case that it will not be available rooms for the hotel that you checked, you will be redistributed at one of the three hotels form the table.

* The hotel payment will be made at the hotel reception on the day of check-out, in Euro, USD or lei – Romanian currency. The reference course for the currency will be the hotel course at the check-out date which is established as a function of the National Bank of Romania reference course.