REGISTRATION FORM

EUROFUSE Workshop on Data and Knowledge Engineering
September 22 – 25, 2004, Warsaw, Poland

Name: 	
(Ms., Mr., Dr, Professor)
Affiliation: 	
(to be used on the badge)
Address for correspondence: 	

Telephone:	 Fax:	E-mail:	

REGISTRATION FEES

Full early registration before July 31, 2004*	EUR 300	
Full late registration before August 31, 2004*	EUR 330	
Full on-site registration*		EUR 350	
Student registration**		EUR 200	

Additional conference banquet ticket	EUR 40	Number of tickets:___
Additional copy of the proceedings volume	EUR 25	Number of copies:___

*Includes one conference banquet ticket and one copy of the proceedings volume
**Requires an official letter from a school. 

TOTAL PAYMENT:   EUR..........
METHOD OF PAYMENT

	By credit card:		VISA 			Mastercard 	
	Card number: 	Expiration date: 	
	By bank transfer to:
	Bank Przemysłowo-Handlowy PBK S.A. O/Warszawa, SWIFT Code: BPHKPLPK
	Account number: PL17106000760000380000049284
	Account holder: Instytut Badań Systemowych PAN, 01-447 Warszawa, ul. Newelska 6
	Subject: EUROFUSE 2004 registration fee of <your name>
The bank transfer must be 'free of charge for the beneficiary' (net of bank charges and commissions). All bank charges or commissions reducing the amount will have to be paid during the registration. Please enclose a copy of a money transfer document with this registration form. Preferrably, please use the SWIFT bank transfer, which is inexpensive and fast.

CANCELLATIONS

In the event of cancellation, and provided that a written notice is received by August 16, 2004, a full refund of the registration fee (reduced by bank costs) will be made. If the written notice of cancellation is received by September 4, 2004, a refund of 50% of the registration fee will be made. If no notice of cancellation is received by this deadline, no refund can be made.

Date	Signature	
		(authorised signature of the cardholder)
Please, send this registration form by fax or mail to:
(a secure Internet credit card payment will be announced shortly in a separate e-mail)
EUROFUSE'2004 Secretariat
Ms. K. Warzywoda, Ms. A. Jozwiak
Systems Research Institute, Polish Academy of Sciences
ul. Newelska 6, 01-447 Warsaw, Poland
Phone: + (48)(22) 837 05 21, 836 81 50	Fax: +(48)(22) 837 27 72	        E-mail: eurofuse@ibspan.waw.pl