<p> ATAVI, International Conference on Acoustics and Vibration</p><p>21-23 March 2016 - Hammamet / Tunisia</p><p>Registration Form</p><p>First Name Last Name Title Laboratory Institution Mailing address Country Zip Code Phone Fax E-Mail </p><p>Method of payment for the account of ATAVI* (check one box): Student Academic Industrial</p><p>450 € 500 € 700 €</p><p>Conference Dinner (35€) Yes No Full registration fees include conference access, coffee breaks, book of abstracts and proceedings on CD </p><p>By bank transfer to ATAVI*: Account No: 01-078-105-1112-0002-85-37 , Swift code or BIC: ATBKTNTT IBAN : TN59-0107-8105-1112-0002-8537 Bank : ARAB TUNISIAN BANK, AGENCE SFAX SOUKRA, Route Soukra Km 3, Kassas el Habib, Résidence HIBA ,3000- Sfax, Tunisie Payment order to the account of ATAVI* Cash or credit card during the conference Hotel booking From : March 2016 to: March 2016 Adults Number of accompanying persons Childrens Single room </p><p>Date: Please send this form no later than 20 February 2016 by fax to +216 74666535 or by email to [email protected]</p><p>* ATAVI : Association Tunisienne d’Acoustique et Vibration Industrielles, ENIS, BP 1173 - 3038, Sfax - Tunisia</p>