ICACT 2008 - Registration Form (group registration)

To register more than 10 delegates, please use this form several times.
Thank you.

First name 1*:
LAST NAME 1*:
First name 2:
LAST NAME 2:
First name 3:
LAST NAME 3:
First name 4:
LAST NAME 4:
First name 5:
LAST NAME 5:
First name 6:
LAST NAME 6:
First name 7:
LAST NAME 7:
First name 8:
LAST NAME 8:
First name 9:
LAST NAME 9:
First name 10:
LAST NAME 10:
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.