ICC20CH 2019 Registration Form

Name: (required) ……………………………………………………………………………

Surname: (required) ………………………………………………………………………

University/Organization :( required) …………………………………………

Preferred Mailing Address :( required) ………………………………………

City :( required) ………………………………………………………………………………

State/Province :( required) …………………………………………………………

Zip/Postal Code :( required) ………………………………………………………

Telephone: (required) …………………………………………………………………

Email (required) ……………………………………………………………………………

 Registration as: (required)

-          Docomomo & TICCIH members

-          professional

-          Students

Early Registration Fees by 15th March 2019: (required)

-          Docomomo & TICCIH members: 3,000,000 rials

-          professional: 3,500,000 rials            

-          Students: 2,500,000 rials   

Registration Fees by 10th April 2019: (required)

-          Docomomo & TICCIH members: 3,500,000 rials

-          professional: 4,000,000 rials            

-          Students: 3,000,000 rials    

Meal preference: with all     or    vegetarian

Tours  (The cost will be announced later):       Tehran           Isfahan

Workshop: 8,000,000 rials

Pursuant to Articles of the Personal Data Protection Law, I hereby express my consent to the processing of my personal data by ICC20CH Conference.