"Austrochip 2005" Registration Form
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I would like to register for the "Austrochip 2005" conference on
October 6, 2005 at the "Gartenhotel Altmannsdorf", Hoffingergasse 26-28,
1120 Vienna, Austria. The registration fee includes the conference
proceedings, breakfast, lunch and coffee breaks.

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Please complete:
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Last Name:
First Name:
Degree:
Institution/Company Name:
Street:
Zip Code:
Town:
Country:

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Please mark with *:
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[ ] Regular conference fee if registered before September 22, 2005 (65 Euro)
[ ] Conference fee for students if registered before September 22, 2005 (25 Euro)
[ ] Regular conference fee if registered after September 22, 2005 (85 Euro)
[ ] Conference fee for students if registered after September 22, 2005 (45 Euro)

Note: Students have to show their students ID at the conference location.

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Please send this e-mail to

contact@austrochip.at

and make a bank transfer to the bank account shown below. Please note that
cancelation of your registration is not possible after September 30, 2005.
For further information please contact the "Austrochip 2005" conference
organization by phone +43-1-58801-38401 or via the e-mail address
contact@austrochip.at

Bank Account Holder: "Oregano Systems - Austrochip 2005"
Bank: "ERSTE Bank der Österreichischen Sparkassen AG"
Bank Identification Code ("Bankleitzahl"): 20111
Bank Account Number: 283-297-048-02
Note to Payee: "Austrochip 2005"
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End of this form