Registration

REGISTRATION

Do you want to be	Attendee Exhibitor Judge Exhibitor and Judge
Name	Surname	First name	Title

Institution/Society/Firm	Association
Mailing Address	Street
	City	Prov./State
	Zip/Postal Code	Country

Phone
Fax
Email
Accompanying Person	Surname	First name

	By 12/31/2003	01/01-09/30/2004	After 10/01/2004
Full Delegate	280 € 224 € *	340 € 272 € *	390 € 312 € *
Accompanying Person	140 € 112 € *	170 € 136 € *	195 € 156 € *
Student	140 € 112 € *	170 € 136 € *	195 € 156 € *
Two days registration	140 € 112 € *	170 € 136 € *	195 € 156 € *
	* France Orchidées member only

	Credit Card (you will choose your card type on the next page)
	Bank Transfer
	Please send direct wire transfer payments:
		To: Banque Populaire Bourgogne Franche-Comté, Dijon Trémouille 00401 Swift Code CCBPFRPPDJN Favour: France Orchidées Acct Nbr:10807 00401 42119456053 02 or IBAN: FR76 1080 7004 0142 1194 5605 302

	A copy of your transfer order MUST be attached to this registration form

	Check in euros : only allowed from a French Bank

You will receive complete information on accomodations and social events later on, but you may already give your preferences.

Accomodation	*Hotel 4 (€ 91 to € 120)**	*Hotel 3 (€ 69 to € 120)**	*Hotel 2 (€ 36 to € 70)**

Social Events
Alliance Breakfasts or lunches	(Number)

If you wish to register by mail:
Send a printed version of this form to:

M-C Belleville
by fax:
+33 (0)385 91 06 01
by mail:
France Orchidee
Palais des Congrès-Expositions de Dijon
BP 67827
21078 Dijon Cedex