International International Marketing Week

Paris

16 – 20 March 2009

Contract with the student – Registration form

Personal Information
Name
First name
Nationality
ID-card number
Address
Date of birth Male Female
Place of birth
Telephone number(s)
E-mail

University Information
Name university
Address

Field and option of study

Study year

Hotel accommodation
I need hostel accommodation for:
 5 nights arrival date: Sunday 15 March 2009
departure date: Friday 20 March 2009

1
The undersigned participates in the programme from and pays € 200 (includes
programme, accommodation, main courses, company visit).

He/she commits him/herself to participate in all the activities of the International

Marketing Week 2009 and to pay the personal costs involved. He/she is expected
to behave correctly during the International Week, both in the university
buildings, as well as in the hostel and during the company visit.

The registration can only be guaranteed after payment of the registration fee.

Date:

Name:

Signature:

Please mail this completed form to Bruno BOUDEAU before 1 February 2009

Bruno BOUDEAU
IUT de Saint-Denis La Plaine
3-5, rue de la Croix Faron 93210 Saint-Denis La Plaine
bruno.boudeau@iutsd.univ-paris13.fr
Fax: 01 55 93 75 15