Troisième conférence européenne de la médiation

Registration You are already registered : email password	To register, please fill in all the fields of the form. If you accept to share your contact information, only your email will be shared. Once your registration is done, you will receive an email confirming that your request has been noted. Thanks to the password that you will find in this email, you will be able to access your information in case you need to modify something.	It will also enable you to register for the workshops. You will be notified by email as soon as the on-line registration for the workshops is open. Do not forget to enclose the printable summary of your request with either your cheque or the certificate testifying your transfer payment. If you have any question, do not hesitate to contact us by phone or email. If you cannot register online, you can also download the registration form HERE.

PERSONAL INFORMATION
	NAME FIRST NAME POSITION ORGANISATION OFFICE PHONE MOBILE PHONE E-MAIL (1 for each person)	ADDRESS POSTAL CODE CITY COUNTRY Language(s) French English Both Do you accept to share your name and contact information with all participants? YES NO
link with mediation
	MEDIATOR STUDENT RESEARCHER	TRAINED IN MEDIATION OTHER (SPECIFY)
WORKSHOPS
You will also be informed by email about the opening of the on-line registration for the workshops the contribution proposals being currently processed by the scientific committee.
FEES
The Conference fees include the programme and participant package, participation to plenary sessions and workshops, coffee breaks and lunches on May 27th& 28th, 2010. The special reception organized on May 27th in the evening requires an additional contribution.	NORMAL FEE : 390 € x DISCOUNT FEE (Members of ANM, EMNI and ESSEC IRENE) 330 € x CONTRIBUTOR FEE (For workshops involving several contributors, please contact inscriptions@europemediation2010.com) 210 € x	OPTIONAL Reception and dinner on May 27th 65 € x TOTAL :
Payment
Please send this form by mail with the cheque OR with a certificate testifying the transfer payment as soon as possible to: Conférence européenne de la Médiation Ile de France (CEMIF) 2, rue Henri IV 92340 Bourg La Reine FRANCE ATTENTION : Registration fees are non-refundable	PAYMENT BY CHEQUE, drawn on a French bank and payable to « Conférence européenne de la Médiation – Ile de France (CEMIF) » SWIFT TRANSFER PAYMENT on the CEMIF bank account RIB : 30004 00839 00010105983 62 Domiciliation : BNP Paribas Bourg La Reine (00839) IBAN : FR76 3000 4008 3900 0101 0598 362 BIC : BNPAFRPPMAS Titulaire : Association Conférence Européenne de la Médiation Ile de France	I would like to receive an invoice YES NO

For more information, please contact Agence Lifting : Tel : + 33 1 46 63 25 93 Fax : + 33 1 45 46 52 05 Email : inscriptions@europemediation2010.com