REGISTRATION FORM

Title*:
Last Name*:
First Name*:
Organisation*:
Address*:
ZIP/Postcode*:
Country*:
Telephone:
Fax:
E-Mail*:
Accompanying Person:

Delegates: Please advise the conference office if you expect to be away during the period immediately prior to the conference and provide a forwarding address.

REGISTRATION

Delegate, Early Bird 250 incl VAT
Delegate, Two Days 300 incl VAT
Delegate, One Day 200 incl VAT
COST Action TU1101 member and students 100 incl VAT
Companion, dinner included (no conference attendence, no poceeding) 150 incl VAT


The registration fee include coffee, snacks, dinner, proceedings during the conference.


For Hotel Booking please use our website to find the hotel and make your own reservation with the hotel.

PAYMENT

Credit Card No.:
Valid:
Security Code:

  I send my credit card information via email(icsc2015@mh-hannover.de) or fax (+49 511 532 64 19)

A cancellation received before May 10th 2015 will be refunded in full, less an administrative charge of € 50. In case of cancellation between May 11 and July 31, 2015, all but EUR 100 of your registration fee will be refunded. A refund will not be made if cancellation is recieved after August 31th 2015. An alternate attendee can be substituted at any time prior to the conference. Please inform the Conference Manager of the substitution.



Hosted by:


in cooperation with:

Landesverkehrswacht Niedersachen

DVR

ETSC

 


 

www.icsc2015.eu


The 2016 conference will take place in Bologna, Italy


Website hosted by
Medizinische Hochschule Hannover