Colloquium on Violence and Religion 2007
July 4 - 8

CONFERENCE REGISTRATION FORM

A. General Information

Name:

Address:  

City:

Country:

Postal Code Number :  

Phone: #

Fax: #

E-mail address:

Institutional affiliation:

B. Summary Costs and Fees
I wish to register as :

COV&R Member € 125
COV&R Member, Student € 65
Non-COV&R Member € 165
Non-COV&R Member, Student € 75

C. Accommodation
The prices for accommodation cover the period from Wednesday 4th July 13.30 hrs – Sunday 8th July 10.00 hrs.

fullboard 4 days, 1 person per room € 390 
fullboard 4 days, 2 persons per room € 290
4 days lunch, dinner, tea/coffee, without bed and breakfast € 140 
dayprice 1 person per room € 110  Indicate the day(s):
dayprice 2 persons per room € 85  Indicate the day(s):

D. Meals
Special dietary needs :

vegetarian
kosher/halal

E. Additional
Participation in recreational program on Friday (Price: € 50)

Yes No

F. (Possible) Remarks

G. Payment

Vrije Universiteit Blaise Pascal Instituut
Bankaccount: 48.81.80.112
IBAN: NL06 ABNA 0488180112
Swiftcode/BIC: ABNANL2A