NordiCHI 2002
Full time student status approval form

To be eligible for registration at student rate please fill in this form and attach official documentation of current full time student status (e.g. matriculation card, or official written statement from supervisor). Submit it together with your registration form. If you are registering online please send the form by fax to Århus Convention, fax: +45 8612 0807.

Registration at student rate is only valid when valid documentation for current full time student status is presented when arriving at the conference registration desk.

First name:
Last name:
Street address:
ZIP / Postal code:
City (state):
Country:
E-mail:
Phone (+country code):
Fax (+country code):

School:
Study programme:
Level (circle one): Under grad,   master,   doctoral 
Start date:
Expected graduation date:

I, the applicant, declare that the above information is correct and that I to my best knowledge will be a full time student in October 2002. I also promise to present valid documentation of full time student status at the registration desk.

Signature:                                                            Date: