Registration Form
First Name :
Last Name :
Affiliation :
City :
Country :
Paper ID :
E-mail
Type of registartion :
Before Feb. 27, 2019After Feb. 27, 2019
Student 200 € 280 €
Full delegate 300 € 390 €
Industrial 380 € 490 €
Additional paper:    Cost: €  (50 € for each additional paper)
Total:
Payment method

Useful notes :

Bank Information: ( Direct and on Site )
Jaguar Travel (for informations : icome2019.tn@gmail.com)
Account holder : Jaguar Travel And Events
Bank name/number : BIAT (71)
Adress : Rue Habib Chatti Centre Alyssa Manar 1 Tunis
RIB : 08 003 0007159001991 54
IBAN (Int. Bank Account Number) : TN59 0800 3000 7159 0019 9154
BIC (Bank Identification Code)/Swift : BIATTNTT

Bank Information: ( For Tunisian )
Bon de commande
For information : (sediki.ezeddine@gmail.com)

Bank Information: Specific Cases (France Laboratories)
EPMI-Ecole de Physique & Mathematiques Indust
BANK : SOCIETE GENERALE
RIB : 30003 01658 00037279714 23
IBAN : FR76 3000 3016 5800 0372 7971 423
SWIFT (BIC) : SOGEFRPP
Domiciliation : CERGY

* All fields are required