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[pic] |PFN 2006 Registration Form

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1. Identification

|Surname:       |First Name:       |

|Title:       |Institution:       |

|Address:       |City:       |

|Post Code:       |Country:       |

|Telephone:       |Fax:       |

|E-Mail:       |

2. Registration Fee

| |Before June 9, 2006 |Before July 5, 2006 |Conference Days |

|Academic Participants |200.00 € |250.00 € |300.00 € |

|Ph.D. Students |100.00 € |125.00 € |150.00 € |

|Other |300.00 € |350.00 € |400.00 € |

(The registration includes the social events below for the registrant)

Total for Registration (A):       Euros

3. Accommodation

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(Rates are per room, per night, including breakfast and taxes)

|Hotel:       |Number of Rooms:    |

|Date of Arrival:       |Date of Departure:       |

|Do you have any special requirements, needs or comments?       |

Nr. of Rooms x Nr. of Nights x Hotel Rate =Total for Accommodation (B):       Euros

4. Social Events

Please indicate which of the following events you (and your spouse) plan to attend:

Thursday Reception: Self (0 €) Spouse (0 €)

Friday Gala Dinner: Self (0 €) Spouse (30 €)

Total for Social Events (C):       Euros

5. Tours

| |Price |Nº of Persons |

|Visit to "Casa de Serralves" – Saturday (14:30 – 18:30) |€ 26 |       |

Total for Tours (D):       Euros

6. Payment

Payment can be done by a Bank Draft issued to Viagens Abreu S.A. (please contact Viagens Abreu, for further details), or by Credit Card. For payment by Credit Card, please fulfil:

I authorise to charge the total amount of (A+B+C+D)       Euros to my: VISA / AMERICAN EXPRESS / MASTERCARD number      . Expire Date:      

Last three numbers of the backside of the credit card(CVV)    

Signature (of Card Holder): ______________________________________________

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|Please send this Form to: Viagens Abreu S.A. / Att. Congress Dept. / Av. dos Aliados 207 / 4000-067 Porto – PORTUGAL / |

|Phone:00.351.22.204 3570 / Fax : 00.351.22.204 3693 / E-mail: congress.porto@abreu.pt |

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