ICACT 2008 - Registration Form (single registration)

First name *:
LAST NAME *:
Company:
Address (1/2) *:
Address (2/2):
City *:
Zip code *:
Country *:
Phone:
Fax:
E-mail *:
Credit card number *:
Credit card valid until *:
Credit card holder *:
Invoice made out to (if different from above):

Data marked with an * is compulsory.
By clicking 'Submit' you hereby acknowledge having read the page "Registration",
its rates and deadlines for registration fees, as well as dates of e-badges e-mailings.
Important!
Upon receipt, please print out, and keep an electronic copy of your e-badge,
since it will give you access to the congress.