Registration

The registration fee for participants covers the access to the meeting, the receipt of the conference programme and abstract book and the social programme as well as daily coffee breaks and lunches during the meeting.

The fee for accompanying persons includes the social programme.

	Paid until March 25	Paid after March 25
Registration fee:	€ 250.-	€ 300.-
Accompanying person fee:	€ 100.-	€ 100.-

Payment details:

Please enter on the remittance EWGLI 2011 + name of the participant

Account holder	Name of the bank	IBAN	SWIFT
AGES	PSK	AT58 6000 0000 9600 6506	OPSKATWW

As soon as the participation fee has arrived on our bank account, your registration will be valid.

Registration form

* obligatory

*Sex:Mrs.
Mr.

*First Name:

*Last Name:

title / function:

*Institution / Company name

Department:

*Address:

*Zip:

*City:

*Country

*Email:

Phone:

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If the invoice address is not equal to the address stated already, please check box and write your invoice address next:

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Institution / Company name

Address:

Zip:

City:

Country

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I will bring an accompanying person:

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Sex:Mrs.
Mr.

First Name:

Last Name:

Social Events:

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I will participate on:

May 25, 2011: Social Event 1 "Heuriger"

May 26, 2011: Social Event 2 "Gala Dinner"

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Schriftgröße: A | A | A