<p> STUDENT REGISTRATION FORM, page 1</p><p>Erasmus-Socrates - European Intensive Programme Translating God(s): Intercultural Theology and Interreligious Studies June 14 to June 25, 2010 Trinity College Dublin STUDENT REGISTRATION FORM</p><p>Personal information (Please type or print clearly in CAPITAL LETTERS) To be filled in and sent before Feb 15, 2010 together with a copy of data page of your PASSPORT to: The Irish School of Ecumenics, c/o Dr. Norbert Hintersteiner, Bea House / Milltown Park, Dublin 6, Ireland First(Given) name: ______Surname: ______</p><p>University / Affiliation: ______</p><p>Postal address: ______</p><p>Postal code: ______City: ______Country: ______</p><p>E-mail address: ______</p><p>Summary of Payment</p><p>Registration Fees Before February 15, 2010 After April 1, 2010</p><p>Registration Fee (Western Europe) 100 Euro  120 Euro </p><p>Registration Fee (Eastern Europe) 50 Euro  70 Euro  Form of Payment (choose one):</p><p> Charge a total of €______ My cheque is enclosed for: €______ Visa  MasterCard Card#______Make payable to “The Irish School of Ecumenics.” It can be sent to: _____ Card Expiration Date (mm/yy) ____ /____ The Irish School of Ecumenics Signature (required) c/o Dr. Norbert Hintersteiner ______Bea House / Milltown Park I agree to pay above amount according to card issuers Dublin 6 / Ireland agreement.</p><p>Irish School of EcumenicsTel: +353 (0) 1 260 1144 Trinity College DublinFax: +353 (0) 1 260 1158 Bea House, Milltown ParkWebsites: www.tcd.ie/ise/ Dublin 6, Republic of Ireland</p><p>Any cancellation or change must be communicated to “local coordinator / professor” and received and confirmed by the Programme Coordinator in official written notice via letter, fax or e-mail before May 1 for 70% refund of total payment. No refund will be granted after this date or for no-show. Should you have any questions, please do not hesitate to contact: Dr Norbert Hintersteiner: [email protected] STUDENT REGISTRATION FORM, page 2</p><p>Topic and Title of Essay / Presentation</p><p>………………………………………………………………………………………………………………………………………………………………………………………</p><p>Abstract to Content of Essay / Presentation (8 lines)</p><p>……………………………………………………………………………………………………………………………………………………………………………………..</p><p>………………………………………………………………………………………………………………………………………………………………………………………</p><p>……………………………………………………………………………………………………………………………………………………………………………………..</p><p>………………………………………………………………………………………………………………………………………………………………………………………</p><p>……………………………………………………………………………………………………………………………………………………………………………………..</p><p>………………………………………………………………………………………………………………………………………………………………………………………</p><p>……………………………………………………………………………………………………………………………………………………………………………………..</p><p>……………………………………………………………………………………………………………………………………………………………………………………… Remember: ESSAY MUST BE SUBMITTED BY MAY 1, 2010, by email to [email protected]</p><p>Your essay fits best in the following thematic area of IP (select one or two thematic areas to which your presentation is a contribution)</p><p> Naming and Thinking God in Europe Today</p><p> From World Mission to Interreligious Witness</p><p> Dialogue of Religions</p><p> Fluid Religions in New Modernity</p><p>Irish School of EcumenicsTel: +353 (0) 1 260 1144 Trinity College DublinFax: +353 (0) 1 260 1158 Bea House, Milltown ParkWebsites: www.tcd.ie/ise/ Dublin 6, Republic of Ireland</p><p>Place: Date: Student Signature:</p><p>Irish School of EcumenicsTel: +353 (0) 1 260 1144 Trinity College DublinFax: +353 (0) 1 260 1158 Bea House, Milltown ParkWebsites: www.tcd.ie/ise/ Dublin 6, Republic of Ireland</p>