ICEFM Montpellier 2017 Registration Form
Location: Montpellier, France
Date: 22-24 November, 2017

Registration fees:
- Academic presenter: 250€ (early bird) / 300€ (full fee)
- PhD student, participant, poster presenter : 150€ (early bird) / 200€ (full fee)

The registration fee includes conference materials, coffee breaks and lunch buffets of the 3 days and the gala dinner on 22th.
For further inquiries please contact: icefm@montpellier-bs.com

Please complete the information below.

Email address
Title
First Name
Your answer
Last Name
Your answer
Preferred Name for Badge
Your answer
Organization
Your answer
Contact Name and Address to send the invoice
Your answer
Telephone
Your answer
Food Preference
Social Events
Breaks and lunches
Payment Full Fee (prior to 30/09/2017)
Required
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