<p> SADA 2007</p><p>For Conference Organisation REGISTRATION FORM Committee use only BI:</p><p>SADA’07 26 FEBRUARY – 02 MARCH 2007 COTONOU - BENIN</p><p>Fill in this registration form and return it before February 20, 2007 either:</p><p> by postal mail to: Colloque SADA – Laboratoire de Mathématique Appliquées de Pau Bâtiment IPRA Université de Pau et Pays de l’Adour Avenue de l’Université – BP 576 64012 Pau  by fax : +33 (0)5.59.40.75.55  by e-mail : [email protected]</p><p>Mr. Mrs Miss Family name: First name: Title: (researcher, teacher, student, non-academic)</p><p>Name of laboratory or company (attach purchase order if your organization pays for you):</p><p>Professional address: Financial department (E-mail): Postal code: City: Country: E-mail: Phone (incl. Country code): </p><p>Participating as: Speaker Delegate Registration is mandatory to gain access to conference and must be done before conference opens.</p><p>REGISTRATION FEES Family name: First name: Before Registration fees include: Feb,20,2007 Full rate 140 € Abstract Student 40 € Lunches Coffee break Gala dinner Company 240 € Accompanying person € Total registration payment</p><p>CONDITIONS OF PAYMENT (tick box) Payment in Euros only to be sent to: </p><p> E-mail: [email protected]  fax : +33 (0)5.59.40.75.55 1 – Bank card Secured Transaction * (VISA, EUROCARD, MASTERCARD ONLY) * Certified SSL Protocol</p><p>2 – Bank transfer (attach copy of bank transfer sheet): Account holder: « Agent Comptable Secondaire du CNRS » 10071-33000-00001000242/18 IBAN: FR76 1007 1330 0000 0010 0024 218 – BIC/SWIFT: BDFEFRPPXXX Bank address: Trésor Public – Trésorerie Générale – 24, rue François de Sourdis BP 908 - 33060 Bordeaux Cedex </p><p>3 – Bank cheque to be made out to « Agent Comptable Secondaire du CNRS » and to be sent to: </p><p>4 – If your organization pays for you: attach purchase order bearing the following information: «Registration fees for Mr. or Mrs X… to the conference « ………………………..», made out to: « Agent Comptable Secondaire CNRS ». Purchase order n°: Invoice needed: yes no CNRS Siret n°: 180 089 013 02458 VAT n°: FR40 180 089 013</p><p>Your receipt will be given to you on the day of your arrival on site.</p>