THE COLOUR OF OCEAN DATA 
The Palais des Congrès, Brussels, Belgium
November 25-27, 2002

CONFERENCE REGISTRATION FORM
 (to be returned before March 31, 2002)

Please complete (type or use capital letters) and return to: Flanders Marine Institute (VLIZ)
					The Colour of Ocean Data
Victorialaan 3, 8400 Oostende, Belgium
					Fax: +32-(0)59-34 21 31

The undersigned wants to be registered as a participant to the above conference:

Mr/Mrs/Dr Surame	First Name	
Title and/or position 	
Institution/Company	
Street	
Postal code	City	
Region/State	Country	
Tel.	Fax	E-mail	

CONFERENCE FEES (in EUR) (please tick appropriate boxes)

	November 
25-27	November 
25	November 
26	November 
27	
Regular		50		20		20		20	
Student		12.5		5		5		5	
Spouse		12.5							

							Total amount remitted	EUR ____________

(all payments must be made in EUR to the order of Flanders Marine Institute, The Colour of Ocean Data, without charges for the beneficiary. Registration is only valid upon receipt of registration fee)

by	 International Postal Money Order 
 Bank transfer to account 280-0771667-69 (Fortis Bank, Thomas Van Loostraat 63, 
      B-8400 Oostende, Belgium)
 Please clearly state name of participant(s) and company or institution

by credit card:   Visa			 Eurocard			 Mastercard
Card No.: . . . ./. . . . /. . . ./. . . .             Expiry date	
	Signature	
Use 1 form per participant (+ possibly spouse)