RIPE26: registration form

[RIPE NCC Staff <]

                              26th RIPE meeting
                         Amsterdam, The Netherlands
                          January 20th-22nd, 1997

                             Registration form
                             =================

Our handling of meeting registrations is automated.  To register for
the meeting, please use the HTML form at the URL
http://www.ripe.net/html/noframes/mtg-form.html
or send the e-mail registration form below to meeting@localhost.
You will receive a notification message that your request has been processed.  

If you have any questions about the meeting or your registration form,
please send your form or any questions to ncc@localhost.

==============================================================================

%START

Please add a value in the 'box' area marked between the square
brackets (i.e. "[" and "]" s). If values are already supplied between
the brackets, please delete all values except one.

PART 1 - Registration

Note this is what will be used for your badge and for the attendee
list, so please take care to fill it in correctly.

1) Your name
        Please enter your name in FULL. First name first, surname last.
        e.g. John Doe
             Mary-Beth Walton

        %NAME   [                                                         ]

2) Your Organisation/Institution

        %ORG    [                                                         ]

3) Your e-mail address 

        %EMAIL  [                                                         ]

4) Country code of organisation
        e.g. IT
             FR
             DE

        %CTRY   [  ]

PART 2 - Payment of Registration Fees

WARNING!! - Note that sending your credit card information via e-mail is in
principle not secure. The payment information will be transmitted in
clear via e-mail. If you do not want to do this, please leave your
credit card details blank in this form, and send them to us by fax.
Please do not forget to mention your name and organisation on the fax,
so there will be no risk in us getting confused.
Our fax number is: +31 20 592 5090


1) Method of payment.
        Payment in advance is greatly preferred.

        (please delete all choices except one)
        %PMETH  [ in advance; credit card / meeting; credit card / at meeting; cash ]

2) Type of credit card
       (please delete all choices except one)

        %CTYPE  [ VISA / American Express / Mastercard ]

3) Card number

        %CCNUM  [                   ]

4) Expiry date

        %CCDATE [                   ]

5) Card holders name

        %CCNAME [                   ]

6) Card holders address

        %CCADDR [                                                         ]

7) Amount to be paid
        Only meeting NLG 105
        Meeting plus RIPE dinner NLG 160

        %AMT    [ 105 / 160 ]

For information about the RIPE Dinner, please see a separate e-mail or
http://www.ripe.net/html/noframes/mtg-dinner.html

%END