Registration form - École Polytechnique de Montréal

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FRC 2014 Joint ACI-fib International Workshop
Fibre Reinforced Concrete: from Design to Structural Applications
Registration form
Comments

Fill information in grey cells of tables below and send it to [email protected]

The registration payment can be made for individual participant by PayPal or bank transfer.

The registration payment can be made for group of participants only by bank transfer. Fill
one general information section for each participant. Put the total registration costs for the
group of participants.
General information
First Name
Last Name
Professional title
Institution
Address:
Country
Email
Telephone
Author
Speaker
Banquet
Yes, provide the paper number :
No:
Yes :
No:
If more than one ticket of banquet is needed, indicate number here:
Supplementary ticket will be sold at the conference if places are available.
Registration costs

The registration costs include a copy of the proceedings, lunches, refreshments at breaks,
and banquet dinner to be held at Hôtel Nelligan in Old Montreal for the full registrants.

Student registration and one-day registration do not include banquet.
Registration type
Early registration (payment due on 31/05/2014)
Late registration (payment due on 30/06/2014)
Student registration * (payment due on 31/05/2014)
One-day registration (payment due on 30/06/2014)
Bank transfer fee (not applicable for PayPal payment)
Fee
Number of
participants
Amount
450 $CAN
525 $CAN
300 $CAN
300 $CAN
40 $CAN
Total
* A scan of a valid student card or attestation must be sent with the registration form.
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FRC 2014 Joint ACI-fib International Workshop
Fibre Reinforced Concrete: from Design to Structural Applications
Registration payment

Select the payment method with a ‘X’ in the first column of the table below.

Provide the information required in grey cell in the last column when applicable.
PayPal
Instructions
1- Go to the conference web site
www.polymtl.ca/frc2014/.
2- Go to the registration page.
3- Find the PayPal portal (see image below) and select
the registration type.
4- You will be transfer on PayPal website, make the
payment.
5- Indicate the transaction number provided by PayPal
in the cell below.
Transaction number
provided by PayPal
Amount paid
OR
Bank transfer
Note 1
Note 2
Amount paid
Account owner
Beneficiary Address
Bank Name
Bank Address
Account number
Swift code
Transit
Mention to indicate
on the document
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Do not forget to add the bank transfer fee of 40 $CAN
in the registration cost.
Provide the information below to your bank.
Ecole Polytechnique de Montréal
2500 Chemin Polytechnique
Montréal (Québec)
H3T1J4
Caisse Populaire Desjardins
1, Complexe Desjardins, Suite 2822
Montréal, Québec, Canada
H5B 1B3
MFI02190140815CAD0
CCDQCAMM
0815-98000
FRC2014 Conference (Prof. J-P Charron)
FRC 2014 Joint ACI-fib International Workshop
Fibre Reinforced Concrete: from Design to Structural Applications
Transmission of information

Name your registration form file with your family name.

Send your registration form to [email protected]

Add your student attestation to the message if applicable.
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