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REGISTRATION
Workshop: Dependence modeling tools for risk management
October 2 - 5, 2017
* MANDATORY FIELDS
IDENTIFICATION*
TITLE*
Ms
Mr
Dr
Professor
Professor Dr
NAME*
Given Name
Family Name
OCCUPATION*
FACULTY/RESEARCHER - WITH GRANT
FACULTY/RESEARCHER - WITHOUT GRANT
POSTDOCTORAL FELLOW
GRADUATE STUDENT (2ND AND 3RD CYCLE)
UNDERGRADUATE STUDENT
ELEMENTARY OR SECONDARY SCHOOL PROFESSOR
INDUSTRIAL RESEARCHER (Industry, Finance, etc.)
UNEMPLOYED
SELF-EMPLOYED
Other
SEX* (for statistical purposes)
Female
Male
AFFILIATION*
Affiliation
Department
Address of Affiliation
City
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CORRESPONDENCE ADDRESS
Please fill out the following if different from the affiliation.
Correspondence address
Address
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TELEPHONE (with dialing code), EMAIL ADDRESS AND WEB SITE
Email address*
Secondary email address
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Twitter
REGISTRATION FEES*
Registration fees are non-refundable.
Registration Fees $CAN
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Student
Postdoct Fellow
Faculty - one day
Faculty
Other (government, industry) - one day
Other (government, industry)
BANQUET
Only one banquet ticket is included in the registration. The cost of an extra banquet ticket is 65 CAN$ per person.
Number of extra banquet tickets required
$CAN
Total banquet
Total banquet
Special menu. If yes, which one?
TOTAL FEES
Total fees $CAN
PAYMENT *
By credit card only.
Credit card information must be valid until the beginning of the workshop.
The following amount will be debited from your credit card.
Payment Card
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Credit card number
Expiry date on credit card MM/YYYY
MISCELLANEOUS INFORMATION
Please write any other information or comment.
