REGISTRATION FORM
This form, when filled in, should be sent to:	Christophe dos Santos
Dynamique Du Langage
Institut des Sciences de L’homme
14 avenue Berthelot
69363 LYON Cedex 07
Email: christophe.dos-santos@univ-lyon2.fr
Fax : +33 4 72 72 65 90	

Title: 		Family name: 		First name: 		

Institution: 		

Street: 		

City: 		Postcode: 		PO Box: 		

State		Country: 		

Phone: 		Fax: 		

Email: 		
REGISTRATION FEES
Before September 30th:
Student 	70 Euros	□
Non-student 	150 Euros	□	After September 30th:
Student 	90	Euros	□
Non-student 	170	Euros	□	
PAYMENT
□ By credit card:	VISA	□	MasterCard	□
Card owner’s name: 		

Card Number: 	_ _ _ _	_ _ _ _	_ _ _ _	_ _ _ _	

Expiration date:	_ _  /  _ _	
□ By cheque from a French bank, payable to: Association Française de la Communication Parlée (AFCP)
□ By bank transfert:
Établissement: LA POSTE 20041	Guichet: 01008 	N°:1565881J029 	Clé : 37
IBAN : FR 93 20041 01008 1565881J029
□ By invoice (for French universities only):
Association Française de la Communication Parlée (AFCP)
SIRET : 440 910 354 00016	APE : 913E	SIREN : 440 910 354
Date : 	 	Signature :