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UHPFRC 2017 Montpellier – October 2 nd to October 4 th , 2017 Registration Form TO BE FILLED AND SENT WITH PAYMENT TO THE SECRETARIAT OF AFGC, BY SEPTEMBER 20 th , 2017 Mr Mrs Dr Prof. Surname Function First Name Company Address Zip Code / City Country Phone Fax E-mail Billing address (if different) Symposium Registration fees – Before June 1 st , 2017 Symposium Registration fees – After June 1 st , 2017 AFGC, fib, RILEM or ACI Member 500 € AFGC, fib, RILEM or ACI Member 600 € Non-AFGC, fib, RILEM or ACI Member 550 € Non-AFGC, fib, RILEM or ACI Member 650 € French Administration, Students 250 € French Administration, Students 300 € Accompanying person 150 € Accompanying person 200 € TOTAL The registration fees for the Symposium UHPFRC 2017 include: access to all lectures, complete paper and electronic version of RILEM PRO 106 Proceedings, lunches of October 2 nd , October 3 rd and October 4 th , coffee breaks during the conference and Banquet Dinner on October 3 rd . Payment For any cost or commission occurred through bank transfers, this will be at charge of each delegate. Important: for bank transfers, please stipulate your name and AFGC-UHPFRC 2017. Send a copy of the bank transfer with your form. Bank transfer to AFGC Account number: BNP PARIBAS 30004 00066 00010003793 67 Swift Code: BNPAFRPPMAS IBAN: FR76 3000 4000 6600 0100 0379 367 For the registrations made with an order form, there are two stages: the participant will receive a pro-forma invoice upon receipt of the order form, then a paid invoice upon receipt of the payment Tick the appropriate boxes I will attend lunch on October2 nd , 2017 I will attend lunch on October3 rd , 2017 I will attend lunch on October 4 th , 2017 I will attend Banquet Dinner on October 3 rd , 2017 Cancellation Cancellation before September 20 th , 2017 : 80% of the registration fees will be refunded Cancellation after September 20 th , 2017 : No refund

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UHPFRC 2017

Montpellier – October 2nd to October 4th, 2017

Registration Form

TO BE FILLED AND SENT WITH PAYMENT TO THE SECRETARIAT OF AFGC, BY SEPTEMBER 20th, 2017

Mr Mrs Dr Prof.

Surname Function

First Name

Company

Address

Zip Code / City Country

Phone Fax

E-mail

Billing address (if different)

Symposium Registration fees – Before June 1st , 2017 Symposium Registration fees – After June 1st, 2017

AFGC, fib, RILEM or ACI Member 500 € AFGC, fib, RILEM or ACI Member 600 €

Non-AFGC, fib, RILEM or ACI Member 550 € Non-AFGC, fib, RILEM or ACI Member 650 €

French Administration, Students 250 € French Administration, Students 300 €

Accompanying person 150 € Accompanying person 200 €

TOTAL

The registration fees for the Symposium UHPFRC 2017 include: access to all lectures, complete paper and electronic version of RILEM PRO 106 Proceedings, lunches of October 2nd, October 3rd and October 4th, coffee breaks during the conference and Banquet Dinner on October 3rd.

Payment For any cost or commission occurred through bank transfers, this will be at charge of each delegate. Important: for bank transfers, please stipulate your name and AFGC-UHPFRC 2017. Send a copy of the bank transfer with your form.

Bank transfer to AFGC Account number: BNP PARIBAS 30004 00066 00010003793 67 Swift Code: BNPAFRPPMAS IBAN: FR76 3000 4000 6600 0100 0379 367

For the registrations made with an order form, there are two stages: the participant will receive a pro-forma invoice upon receipt of the order form, then a paid invoice upon receipt of the payment Tick the appropriate boxes

I will attend lunch on October2nd, 2017 I will attend lunch on October3rd, 2017 I will attend lunch on October 4th, 2017 I will attend Banquet Dinner on October 3rd, 2017 Cancellation

Cancellation before September 20th, 2017 : 80% of the registration fees will be refunded

Cancellation after September 20th, 2017 : No refund