CECOP - CICOPA EUROPE
European Confederation of
Worker Cooperatives,
Social cooperatives and
social and participative enterprises
CECOP European Seminar
“SOCIAL ENTERPRISES AND WORKER COOPERATIVES
Comparing models of social Inclusion and corporate governance”
MANCHESTER, 9 NOVEMBER 2006
REGISTRATION
Please use capital blocks or type and return it as soon as possible to
Olivier Biron – CECOP AISBL – rue Guillaume Tell 59b – BE-1060 Brussels
BY E-MAIL [email protected] OR BY FAX (32/2) 543 10 37
I. PARTICIPANT
NAME, SURNAME
II. ADDRESS
ORGANISATION
ADDRESS:
TYPE OF ORGANISATION
POSTAL CODE:
CITY:
TEL.
MOBILE PHONE FOR URGENCY:
FAX
E-MAIL
(co-operative, mutual society, association, foundation,
NGO, local authority, ministry, trade-union, university,
training institute, other)
ACTIVITY SECTOR
(only for co-operatives or co-operative organisations)
:
III. REGISTRATION FEES
PRICES IN EUROS
COUNTRY:
Please tick the appropriate box
Before 15th October 2006
After 15th October 2006
 from the 25 EU countries and EFTA states
120 €
160 €
 from United Kingdom
90 €
120 €
 from the other countries
65 €
90 €
IV. ACCOMMODATION (Selection of 4 hotels near the venue of the conference & the Regional Assembly)1
ONLY IN CASE YOU HAVE NOT ALREADY BOOKED YOUR ACCOMMODATION WITH
COOPERATIVES EUROPE FOR THEIR REGIONAL ASSEMBLY
FOUR STARS ****
SINGLE
200 €
1
Price per night, breakfast included
THREE STARS ***
DOUBLE-TWIN
230 €
SINGLE
110 €
DOUBLE-TWIN
110 €
Arrival date :
Departure date :
Type of room :
 Single room
-
 Double room
-
 Twin room (2 beds)
Hotel category :
 ****
 ***
Number of nights :
TOTAL :
For double and twin rooms, please indicate the name of the co-occupier
1.
V. RECAPITULATIF INSCRIPTION
 1 x Participant Registration fees
€
Total Accommodation
€
GRAND TOTAL
€
(number of nights x price of the room)
XII. OTHER REQUESTS
VII. PAYMENT MODALITIES (Cheques are not
 Services for disabled persons (please specify)
 Other needs (please specify)
XIII. WARNINGS
accepted)
Via bank transfer (only before 20th October 2006) on
the account n°736-4025002-51 (Banque KBC – rue du
commerce 87 – 1040 Bruxelles – Swift code: KREDBEBB IBAN code : BE75 7364 0250 0251) quoting obligatory
« CECOP SEMINAR 2006 + name of the representative
person ». Account holder : CECOP AISBL – rue Guillaume
Tell 59b - 1060 Bruxelles.
Payment proofs enclosed. The bank charges will
be supported by the participants.
Via Credit card
 American Express
 Mastercard
1.
2.
3.
4.
 Diners Club
 Visa Card
 Personal credit card  Professional credit card
Number :
Owner name
(organisation or person) :
(professional card) :
Expire date :
Total amount in € :
Date and signature :
Invoicing address if different of the abovementioned address:
The registrations will be confirmed in written.
The registrations will only be valid
once the payment has been done on
the basis of the enclosed payment
proofs.
The secretariat advises you to send
your registration as soon as possible
to give a better answer to your needs
and choices.
The secretariat will not be able to
guarantee any room booking after 20th
October 2006.
Cancellations will not be reimbursed
but substitutions will be accepted.
DATE AND SIGNATURE