::Colorectal Club 2009:: Registration

16th INTERNATIONAL | PAEDIATRIC COLORECTAL CLUB MEETING | 15th - 16th of JUNE 2009

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Information

Fields marked with ^*) must be filled out!
All amounts in EUR.

A. Participant

	Salutation	Mr Ms/Mrs Title:
^*)	First Name
^*)	Last name
^*)	Institution/Department
^*)	Street
^*)	City / ZIP	/
^*)	Country	other:
^*)	Phone
^*)	E-mail
	Reduced fee (Students and Nurses)

B. Accompanying person(s)

Name

C. Congress fees

Registration:	before May 15	after May 15	Persons
Participant	EUR 220,--	EUR 250,--	[1]
Accompanying persons	EUR 130,--	EUR 150,--	[see B.]
Nurses and Students	EUR 130,--	EUR 150,--	[1]

D. Social program > more info

Date	Program	Persons incl. accomp.	Price per Person
June 14	Welcome Reception		incl.
June 15	Guided city tour		incl.
June 15	Dinner		incl.
June 16	Dinner		incl.
June 16	South Styrian Wine Route		€ 51,-
June 21.-24.	Post Congress Tour		€ 550,-

E. Payment

Credit card payment (+4% extra-charge):

Mastercard Visa
Cardholder
Card number
CVV	Use at your own risk! More information
Valid until (MM/YY)	/

Credit card payment without internet:
includes a 4% extra charge.

Print this PDF file and fax it to the congress office: PDF

PermissionCreditcard.pdf

Bank transfer:

Bank: Raiffeisenbank Lieboch-Stainz, Rupert-Schmid-Platz 1, 8501 Lieboch
Bank code: 38210
Account No: 34.306
IBAN: AT223821000000034306
SWIFT/BIC code: RZSTAT2G210


Total amount:		EUR 250,-

Cancellation conditions

Cancellations must be sent in written form to the congress office.
Until four weeks before the begin of the congress the cancellation fee is EUR 10,- After that it increments to EUR 50,-


Contact: Congress Office
Gudrun Raber Department of Pediatric and Adolescent Surgery Medical University of Graz Auenbruggerplatz 34 A-8036 Graz/Austria Phone:+43/316/385-3762 Fax: +43/316/385-3775 Email: kinderchirurgie@meduni-graz.at

Zuletzt bearbeitet am Fri, 20. February 2009, 15:35 von Andreas Schmidt

16th INTERNATIONAL PAEDIATRIC COLORECTAL CLUB MEETING 15th - 16th of June 2009 @ Graz, Austria - Organized by the Verein Für Kinderchirurgie

Information

Contact: Congress Office