MMM3 Registration form
Please complete this document electronically in Word by typing and ticking ( or ).
Personal information :
Last name		
Middle name initials		
Given name		
Nationality		
Institution / Organisation		
Unit / Department		
Function (student, Prof.,...)		
For students : supervisor name		
Street address		
Post code		
City		
Country		
Phone		
Fax		
E-mail		
For students : supervisor’s e-mail		
Author list and title(s) of the presentation(s), an asterisk indicates the contribution you are willing to submit for peer-reviewed publication :		

MMM3 Registration fees : 
The registration fee covers registration and secretarial costs, access to the scientific sessions, tea breaks and lunches, a conference bag with a copy of the official MMM3 Abstract Book and relational items, and participation in the mid-conference excursion.
International participants (in EUR)
Please tick your fee	Industrialised country	Developping country	
	Student* 
(MSc)	Researcher
(PhD)	Student*
(MSc)	Researcher
(PhD)	
Early bird
(payment before 31/08/2011)	 250	 350	 150	 250	
Normal
(payment after 31/08/2011)	 350	 450	 250	 350	
Late
(payment from 01/01/2012)	 500	
* Student participants need to include a scanned copy of their student card or recent diploma (academic year 2010-2011, 2011, 2011-2012 or 2012) and the end of this document, and will automatically compete in the Best Student Presentation Award.
N.B. Accompanying participants should register as a student.

Sri Lankan participants (in EUR)
Special rates apply for Sri Lankan participants from universities, governmental (GOV) and non-governmental organisations (NGO), private companies, and accompanying persons (Acc) :
 
Please tick your fee	Academic	Non-academic	
 	Student 
(MSc)	Researcher
(PhD)	GOV	NGO	private	Acc	
Early bird
(payment before 31/08/2011)	 
60	 
90	 
120	 
150	 
180	 
120	
Normal
(payment after 31/08/2011)	 
90	 
120	 
180	 
210	 
240	 
180	
Late 
(payment from 01/01/2012)	 45000	
On-site registration**	 10000 per day	
* To ease calculation 60 EUR = 10000 LKR.  This conversion rate will be applied for on-site payments.
** for on-site registered participants conference bags are subject to availability.

MMM3 Mid-conference excursion :
Please indicate below which mid-conference excursion you want to register for :
	1st choice	2nd choice	3rd choice	
1. Selected mangrove communities (lagoon, riverine, basin,…) of Galle-Unawatuna, Rekawa, Kahandamodara and Kalametiya incl. the SFFL Kiralakele Mangroves Resource Centre ("Sonneratia caseolaris juice centre")				
2. Udawalawe National Park, the Udawalawe Irrigation Scheme and its downstream mangrove lagoons;				
3. Yala National Park and the mangrove of Palatupana Lagoon (if road conditions permit);				
4. Ancient and recent tsunami-affected sites in the South of Sri Lanka and rehabilitation projects, incl. the SFFL Fiberboat Training Centre;				
5. Rainforest at the Sinharaja Forest Reserve				

Please note that each of the mid-conference excursions is limited by a minimum and maximum number of participants.  The organisers will respect your choice to the best of their abilities.

MMM3 Conference dinner :
Please tick whether you intend to participate in the conference dinner (the extra cost for this is 40 EUR and includes drinks) :
 Yes	40 EUR		 No 0 EUR

MMM3 Pambala-Chilaw Lagoon Workshop :
The MMM3 Pambala-Chilaw Lagoon Workshop has only a limited number of available places and is open to MMM3 Conference participants only.  Participation in the workshop includes transport from the MMM3 Conference venue in Matara to the MMM3 Workshop venue (± 250 km on 7-8 July 2012), hotel accommodation and guided tour in Colombo on Saturday 7 July, accommodation in Pambala-Chilaw Lagoon on Sunday 8 July 2012), and access to the workshop venues and facilities, transport, accommodation and catering (breakfast, lunch, dinner and tea-breaks) at Pambala-Kakkapalliya from Monday 8 July 2012 till Friday 13 July 2012.  The price for participation is 500 EUR.  Currently no MMM3 funding is available to cover participation in the MMM3 Workshop.

Please tick whether or not you want to participate in the MMM3 Pambala-Chilaw Lagoon Workshop :
 Yes, 500 EUR		 No, 0 EUR

Special requirements :
Please indicate in the frame below any special requirements you may have :

MMM3 Refund policy :
Registered participants who are unable to attend the Symposium must cancel their participation in writing before 30 April 2012 if they wish a refunding of paid fees. No refunding request can be accepted after this date. All refunds, minus an administration fee of 100 EUR, will be processed after the Conference and Workshop.
I am a
 regular participant and I hereby declare to have filled the 4 pages of this registration form and to make the payment of the values ticked above today (for more information see ‘Payment’ on the ‘Registration and Practical Information’ section on the MMM3 website);  
 participant applying for funding and I hereby declare to have filled the 4 pages of this registration form and will delay decision on participation and delay payment until I have received feedback on funding from the conference organisers.
Date of registration :		
Signature :		

Student participants need to include a scanned copy of their student card or recent diploma (academic year 2010-2011, 2011, 2011-2012 or 2012) here :

Please save the completed registration form as follows:  
- Feel free to delete the conference logo in order to reduce the file size.
- Save as MMM3underscorelastnameunderscoreregistration.rtf. Keep signs in the family name but do not use spaces; in case of a composed name with a space write as one word but capitalise each part (e.g., MMM3_Koedam_registration.rtf, MMM3_Dahdouh-Guebas_registration.rtf, MMM3_Wang’ondu_registration.rtf, MMM3_NfotabongAtheull_registration.rtf).  
- Return by e-mail to : mmm3@ulb.ac.be