Equal is not enough

Dealing with opportunities in a diverse society

All fields with asterix(*) are required.

Registration form
Sex	Male Female
Name *
First name *
Title * (to appear on batch etc..)
If Other
Organisation
Country *
Postal code & City *
Address *
E-mail *
Phone (including country code)
Fax (including country code)
Days of attendance *	Wednesday, September 13, 2006 (evening programme) Thursday, September 14, 2006 Friday, September 15, 2006
Have you submitted * an abstract?	Yes No
Are you actively participating? * (presenting a paper/keynote/...?)
If yes, how?	Paper Keynote Session chairman Advisory board
Subscription type *
	Send an invoice, please.
If you require an invoice and the address is different from the one above, please fill in here	Same as above
If you are a student, please send a copy of your studentcard by email (equalisnotenough@ua.ac.be) or fax (+32 (0)3 220 43 82) to the organisation, only then your subscription as student will be accepted. There is no possibility for seperate subscriptions for one or two days.
Account number (from which the tranfer is conducted)
Only payment by banktransfer is possible. Please transfer the full amount on: IBAN code: BE12735014017292 BIC: KREDBEBB Account number: 735-0140172-92 Please write following message on your transfer: "SC200605 Equal Conference + your name + your surname"
Food	Vegetarian Non-vegetarian
Do you need special accessibility services?
If you have other questions or remarks, please write them here