REGISTRATION FORM
Deadline
for registration was April 7, 2006 (prolonged)
|
| First
Name |
|
| Surname |
|
Department/Institution
/Company/Education
(if student) |
|
| Section (if relevant) |
|
Address (office,
home if student) |
|
| Zip and City |
|
| Country |
|
| Phone |
|
| Mobile (cellular)
phone |
|
| Telefax |
|
| Email |
|
| Full price
(non-members) |
€
375:-
|
Member of the Society for Zoonotic Ecology and Epidemiology
|
|
–
€ 50:- |
Hotel reservation at the
venue
(If you arrange your own stay, please leave boxes untagged)
|
|
|
Late registration
add-on |
After April 7
(no guarantee for place) |
+ € 30:- |
| To assist us in our
planning, please indicate if you plan to participate in the following: |
Lunch Wednesday 3 May (1st day, open 11.30–13.00)
Lunch Friday 5 May (last day, open12.30–14.00)
Coffee Friday 5 May (after closure of meeting)
|
| Food requirements |
|
| Need of assistance,
room mate, other requests |
|
Participation in
Optional tour |
Yes (from € 160, more information
here)
Single room prefered (add € 56 for two nights) |
|
As a confirmation of your registration, you will receive an email
or fax confirmation containing instructions for payment.
PLEASE OBSERVE THAT REGISTRATION IS BINDING!
|
