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On-line early registration 2019 for M10-M23

YOUR INFORMATION
*Civility
*Family name (Capital letter)
*First name
*Nationality
*Company / Institute / University
*Laboratory
*Professional Address
*Zip Code
*City
*Country
*Phone
*Email
Status
INVOICE INFORMATION
*Invoice Company name
*Invoice Address
*Invoice Zip Code
*Invoice City
*Invoice Country
Order N°
Name of Supervisor/Accounts Responsible
Phone (Person to contact)
Email (Person to contact)
*Choice of the module
PAYMENT
*Early Registration :
Early Registration : 320 euros
Industrial early registration : 580 euros
Reduced registration : 150 euros (for self-financed Brazilian, Chinese, Indian, Russian and Turkish PhD students attending module in their country.)
ID Card for reduced Registration fee
Maximum Size sends : 1 Mo / Extension (s) permitted (s) : pdf,doc,jpg
The size of your file exceeds the allowed size. Please reduce your file.
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*ID card or student card
Maximum Size sends : 1 Mo / Extension (s) permitted (s) : pdf,jpg,png,gif
The size of your file exceeds the allowed size. Please reduce your file.
The extension of your file is not permitted.
*Method of payment
Order form
Check
Bank transfer
Credit Card / Paypal
*Type de participant
Invoice date

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Price inc. VAT :