International Law Week : List With Lecturers And Students From

International Law Week : list with lecturers and students from

(University College)

Please, mail this form to Alberik Hubin ([email protected]) before October 19th, 2009. Name of the University College: Address: Contact person: Subscription fee participation International Law Week :

students x €200 (*) =

€

Visit of Antwerp on Sunday (optional) :

students/lecturers x €15 =

€

nights ( € 20 per night per person in the youth hostel ) :

students x €20

€

Total

=

€

Please, deposit the subscription fee before November 15, 2009 on the following account. Please mention ILW2009 and the name of your School: IBAN: BE07 7865 4858 2066 BIC: GKCCBEBB Dexia Bank NV Pachecolaan 44 B-1000 Brussel

Lecturer(s) NAME AND FIRST NAME

E-MAIL

MOBILE PHONE

DATE ARRIVAL

DATE DEPARTURE

VISIT ANTWERP SUNDAY DEC 6TH, 2009

.12.2009

.12.2009

yes no

.12.2009

.12.2009

yes no

(*) Workshops on Monday, Thursday and Friday in Heverlee (KHLeuven). On Tuesday and Wednesday in Brussels (H.E.Ephec).

Enrolment International Law Week Belgium 2009

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Students

NAME AND FIRST NAME

E-MAIL

NUMBER ID CARD

DATE OF BIRTH DATE ARRIVAL

DATE DEPARTURE

VISIT ANTWERP SUNDAY DEC 6TH, 2009

.12.2009

.12.2009

yes no

.12.2009

.12.2009

yes no

.12.2009

.12.2009

yes no

.12.2009

.12.2009

yes no

.12.2009

.12.2009

yes no

Alberik Hubin phone: +32/ 16 375 314

Enrolment International Law Week Belgium 2009

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