Registration International Jheronimus Bosch Conference

 Date 23, 24 and 25 May 2007
 Location Jheronimus Bosch Art Center, ’s-Hertogenbosch, the Netherlands
 Costs

€ 200 for the entire, three-day program
€ 75 per day

Student discount 50% (must show valid student ID)
Participants pay for their own travel and accommodation costs


Fields marked with * are compulsory

Registration form

Organization *

 
Titles

 
Initials *

 
Gender *
 Male
 Female
 
(Last)Name *

 
Position

 
Address *

 
Post code *

 
City *

 
Country *

 
Tel. No. *

 
Fax

 
E-mail *

 
Dietary preference

 
I wish to take part in the daytime program on
 23 May
 24 May
 25 May
 
I am a student and will simultaneously fax or e-mail a copy of my valid student ID along with this registration form.
 Yes
 No
 
I would like to join the dinner on the evening of Thursday May 24 between 6:00 p.m. and 9:00 p.m. This costs € 75.
 Yes
 No
 
Arrival date *
Klik hier om een datum te selecteren
 
Place of arrival

 
Departure date
Klik hier om een datum te selecteren
 
Place of departure

 
Transport by
 Car
 Train
 Airplane
 
Conference participants are expected to make there own hotel reservations. Do you intend to book a hotel room? *
 Yes
 No
 
We would also like to know how you found out about the international Jheronimus Bosch conference.
 via a Jheronimus Bosch Art Center announcement
 via a Codart newsletter
 via a mailing from the Centrum voor Kunsthistorische Documentatie
 via a mailing from Historians of Netherlandish Art
 
and/or other source, i.e.:

 
You can also send the above information to:
Fax: 00 31 73 690 15 16
Address: Jheronimus Bosch conference organization office (Artishock), Koningsweg 66, 5211 BN ’s-Hertogenbosch, the Netherlands
T 0031 (0)73 6105735
 
 

* = Required field