| Dinners and Excursions only
To be mailed, send and pay before July 15th 2006.
Info number call: +31 6 188 345 02 or e-mail to: Henk Bril
Payments to:
Ned. ver. Waarnemers v. Sterbedekkingen
Benedendorpsestraat 18
7038 BC Zeddam
Postbank Account nr 836 56 00
IBAN code NL97 PSTB 0008 3656 00
BIC PSTBNL21
Keywords: ESOP 2006 and P/your name
Or : ESOP 2006 and S/your name
Fees are only valid when you are registered as a participant or partner.
Please print legibly!
Or download the pdf  or Print Version.
Fees for members of DOA, IOTA-ES and their partners,
between brackets fee for non members.
O Buffet Participant on Friday August 25 € 0.00 (€ 0.00)
O Buffet Partner on Friday August 25 € 45.00 (€ 55.00)
including lunches on Saturday and Sunday
O Buffet Partner on Friday August 25 € 30.00 (€ 40.00)
excluding lunches on Saturday and Sunday
O For Partner: Lunch at Saturday € 12.50 (€ 15.00)
O Social dinner Saturday August 26 € 30.00*
O Mark here when your partner is participating the social dinner
O For Partner: Lunch at Sunday € 12.50 (€ 15.00)
O Excursion ESA, incl. lunch, Monday August 28 € 25.00 (€ 35.00)
O Mark here when your partner is participating this excursion
EXCURSION TO ESA IS AT ITS LIMIT (JUNE 3RD 10h00).
IF YOU SUBSCRIBE YOU WILL BE ON A WAITING LIST WHEN
SOMEBODY CANCELS.
PARTICIPANTS WILL BE REPLACED IN SEQUENCE OF REGISTERING.
O Canal tour Monday August 28 incl. dinner € 35.00 (€ 45.00)
O Mark here when your partner is participating the canal tour
O Excursion Boerhaave and Sonneborgh,
including lunch, Tuesday August 29 € 45.00 (€ 50.00)
O Mark here when your partner is participating this excursion
O Excursion Delta Works,
including lunch, Wednesday August 30 € 55.00 (€ 65.00)
O Mark here when your partner is participating this excursion
Title: (Prof. Dr. Mr. Mrs. etc): ____
Full name:
______________________________________________________
Address:
______________________________________________________
Town:
______________________________________________________
Zip code:
______________________________________________________
Country:
______________________________________________________
Telephone:
______________________________________________________
E-mail:
______________________________________________________
Web page **:
http://________________________________________________
Name and signature:
______________________________________________________
Date:
______________________________________________________
* This may change.
** We place link on this site of your site.
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