Registration for the 9^th event

To register for the event on 11 December 2008,
please complete this form:

First name

(*)

Last name

(*)

Company

(*)

Street

(*) Number (*)

Postal Code

(*) City (*)

E-mail address

(*)

Job title

(*)

Member ID

Entrance fee

I am not a member EUR 30,00 (includes 2008 membership fee) I am an ACM member, but not SIGCHI.be member EUR 20,00 (includes 2008 membership fee) I am a student, but not SIGCHI.be member EUR 20,00 (includes 2008 membership fee) I'm already a member - entrance fee EUR 15,00 (*)

(*) indicates a required field

Your registration will be accepted after payment of the membership / entrance fee.
Membership is obligatory for this event.