Personal data delegate

Company / Institute
Department
Title (e.g. Prof.)
Student ID*
*Required to benefit from the student fee
Family name*
Prefix (e.g. van)
First name*
Gender*female
male
Job title
Address*
Postal code*
City*
Country*
Mobile
E-mail address*
CC e-mail address
Dietary requirements
Register as:*Early fee until 18-10Late fee after 18-10
Regular fee (incl. SSE membership)317.00 417.00 
Student fee (incl. SSE membership)255.00 355.00 
Regular fee (meeting only)225.00 325.00 
Student fee (meeting only)185.00 285.00