REGISTRATION FORM
17TH TRIENNIAL CONFERENCE OF THE EAPR
Brasov, July 06 to 10, 2008 |
- Please fill in one separate form for each participant
- Fields marked with "*" are obligatory
- Send this Registration Form before January 31, 2008 by e-mail, Fax or regular mail to the Organizing Committee (early registration):
- Final Registration: June 6th
- Final Submission of Abstracts: March 15th
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| 1. GENERAL DATA |
| Title: * |
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| Family Name: * |
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| First Name: * |
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| Estimated arrival: * |
July 2008 |
| Departure: * |
July 2008 |
| Organization: * |
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| Address: * |
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| Town: * |
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| Zip code: * |
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| Country: * |
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| E-mail: * |
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| Tel: * |
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| Fax: |
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| 2. PRESENTATIONS |
| Total number of presentations: * |
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- Please fill in one separate box for each presentation. Indicate oral/poster in each case. Use the copy, cut and paste facilities.
- Your Description will help the Scientific Committee to evaluate your contribution.
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| Presentation 1 |
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| Title: |
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| Description max 100 words: |
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| Presentation 2 |
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| Title: |
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| Description max 100 words: |
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| Presentation 3 |
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| Title: |
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| Description max 100 words: |
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| Presentation 4 |
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| Title: |
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| Description max 100 words: |
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| Presentation 5 |
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| Title: |
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| Description max 100 words: |
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| 3. PAYMENTS |
- Please indicate your Status and No. of AP below and enter the total amount
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| Status |
Payment time:
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| Before 31.01.2008 |
After 31.01.2008 |
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EAPR member |
350 Euro |
450 Euro |
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Company (EAPR member) |
420 Euro |
550 Euro |
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Non-member |
475 Euro |
575 Euro |
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Student |
190 Euro |
240 Euro |
- Students have to provide an accredited document by separate mail, e-mail or Fax
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Number of Accompanying Persons |
230 Euro per Accompanying Person |
280 Euro per Accompanying Person |
- Please fill in their First names and Family names in the rows below
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| Person 1: |
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| Person 2: |
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| Person 3: |
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| Person 4: |
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| Person 5: |
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| Total amount due (Euro): |
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Payment Method / Description |
- Please, indicate your Payment Method below
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I will remit the total amount in EURO (
free of any bank charges
) by:
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Cheque made payable to "INCDCSZ- BRASOV" |
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Bank transfer to the bank:
RAIFFEISEN BANK (RZB), ROMANIA, BRASOV
IBAN: RO 57 RZBR 0000060009181581
SWIFT:
RZBR ROBU
STREET MIHAIL KOGALNICEANU 3, BRASOV, ROMANIA
Account holder:
INCDCSZ
BRASOV
Subject: "EAPR2008".
* Indicate
clearly
the participant name(s) of the registration fee! |
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4. Special bus line - OPTIONAL!!!
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| 5. COMMENTS |
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