Registration of participants

Registration of Participation for the DEXA 2001

DEXA Conference, DEXA Workshop, DaWaK Conference, EC-Web Conference

Personal Information (* indicates required fields)

	Ms. Mr.
Last Name*:
First Name*:
Title:
Affiliation/Company*:
Postal Address*:
City*:
State:
Zip*:
Country*:
Phone:
Fax:
Email*:

Each participant will receive 2 proceedings. Please indicate

DEXA Conference
DaWaK Conference
EC-Web Conference
DEXA Workshop

Please indicate the workshops you are interested in

WEBH2001	PaDD'2001	NBiS'2001	LUMIS 2001
MIW'2001	El. Gov.	TAKMA 2001	WBC'01
MDDS'2001	HoloMAS'2001	INBOSA 2001	e-Negotiations
LISA 2001	QPMIDS 2001	KEES 2001	DLib2001

Please indicate the social events you are going to attend (for free)

Welcome Drink: 03-09-2001
Conference Dinner: 04-09-2001
Mayor's Reception: 05-09-2001

Payment

	before 31.7.2001	after 31.7.2001
reduced fee for members of universities	Euro 450,--	Euro 500,--
regular fee	Euro 500,--	Euro 550,--

additional dinner ticket

Euro 40,--

I am a member of a university: no: yes:

Total amount to be paid:

Form of Payment:		Card number:
Card exp. date:		Card holder:

(Bank: Raiffeisen Landesbank Oberösterreich (Austria); S.W.I.F.T Address: RZ 00AT 2 L, BLZ bank code 34000; Account No. 5.711.098)

SECURITY NOTICE: The submission of this form will be performed with a reliable encryption. If the level of security provided by this transmission (anonymous certification) does not satisfy you, you are kindly asked to submit only the first 12 digits of your credit card. The last 4 digits of your credit card with your name should then be sent by fax to the DEXA registration office (FaxNo: +43-732-2468-9308).