INTERNATIONAL ASSOCIATION OF HYDROGEOLOGISTS IRISH … · “Integrated Hydrogeology: Contemporary...

INTERNATIONAL ASSOCIATION OF HYDROGEOLOGISTS

IRISH GROUP “Integrated Hydrogeology: Contemporary Principles, Policy and Practice”

REGISTRATION FORM

Tullamore Court Hotel

Tullamore

Co. Offaly

Tuesday 21st –

Wednesday 22nd

April 2015

PAYMENT INSTRUCTIONS RATES

Early Bird Rates (Available until 3rd April 2015)

IAH Member €180

Non-member €200

Standard Rates

IAH Member €200

Non-member €220

Full-time student/unemployed (member) €60

Full-time student/unemployed (non-member)

€90

Deadline for registration: Friday 10th April 2015

The conference fee includes conference attendance, bound copy of proceedings, refreshments and lunch on both days, and a social evening event to include a light dinner.

(In order of preference)

Electronic Funds Transfer

Account Name: IAH Irish Group

Account Address: AIB, 52 Upper Baggot St., Dublin 4

Account No: 41308040

Sort Code: 93-10-63

IBAN: IE52AIBK 931063 41308040

Please include delegate name in narrative/description

Cheque

Payable to: IAH (Irish Group)

Post to: IAH Treasurer, Groundwater Section, Geological Survey of Ireland, Beggars Bush, Dublin 4

Payment Method

Electronic Fund Transfer:

Cheque:

DELEGATE DETAILS

Please complete and return this registration form by email to conference2015@iah-ireland.org

Organisation: Your reference:

To assist us with managing numbers please indicate intention to attend the following:

Tuesday Social Evening, Tullamore Dew Visitors Centre: Food Only

Food and Whiskey tasting tour

Unable to attend

Monday Technical Fieldtrip

Wednesday Technical Workshop