CESEP 09

Registration Form

• To submit your registration at CESEP'09, please fill all the fields in the form. Once submitted, an acknowledgment of receipt will be sent to you by e-mail. Please provide a valid email address.

CONFERENCE PARTICIPANT REGISTRATION FORM

Title (Dr/Mr/Mrs/Miss):

Surname:

First name:

Company:

Position:

Address:

Postcode:

City:

Country:

Phone:

Fax:

E-mail:

ACCOMPANYING PERSON

Title (Dr/Mr/Mrs/Miss):

Surname:

First Name:

REGISTRATION'S RATE (including VAT)

EARLY REGISTRATION
Until July 15th, 2009

LATE REGISTRATION
After July 15th, 2009

STUDENT
(graduate)

300 €

400 €

REGULAR
(postdocs, seniors)

500 €

600 €

ACCOMPANYING PERSON

250 €

Select a RATE:

ACOMPANYING RATE:

Registration fees include access to the conference rooms, conference proceedings documents, welcome cocktail, lunches, cofee breaks and conference dinner (Social program for the accompanying persons is not included)

ACCOMMODATION

AMARAGUA HOTEL
(Conference Center)

Double
(100 €/room/day*)

Single
(80 €/room/day*)

HOTEL/STUDENT RESIDENCE

Double
(80 €/room/day*)

Single
(46 €/room/day*)

Select an ACCOMODATION:

*VAT and breakfast Included

Arrival date
(dd/mm/yyyy):

/ /

Departure date
(dd/mm/yyyy):

/ /

Number of nights:

Please press button to calculate your total amount

Amount (€)

Registration Fee

Acompanying Person

Acommodation

Total

PAYMENT TERMS

All payments will be charged in Euros. You can choose one of the following two options

Select a PAYMENT:

• Bank transfer (Please refer details on your invoice)

Banco Santander Central Hispano
Account Nº: 0049 3011 82 1110085921
IBAN: ES79 0049 3011 1110085921
SWIFT: BSCHESMM

Please note that the handling charge for the remittance must be paid by the participant. Please, send a copy of the payment form to Andalucia Travel S.A. (see information below) by fax or e-mail.

• Credit Card (An additional 2% will be charged as taxes)

Select a CREDIT CARD:

Credit Card Owner:

Card Nº:

Expiry Date(mm/yy):

BILLING DETAILS (if different from the information previously provided)

Invoicing Body:

Title (Dr/Mr/Mrs/Miss):

Name on the person or institution on the invoice:

Address:

Postcode:

City:

Country:

Phone:

Fax:

Email:

ADDITIONAL INFORMATION

Any other information you may need on hotel reservation, transportation, etc., please contact:

Andalucía Travel S.A.
Dolores Sánchez or Lucia Nuñez
CIF: A29053998
Tlf: +34 952 383 899
Fax: +34 952 376 745
e-mail: atravelutl@e-savia.net

IMPORTANT INFORMATION

Registrations will not be confirmed until payment is received. Incomplete registrations will not be processed. Upon receipt of your registration form with the payment, you will receive a confirmation by email.

CANCELLATION POLICIES

Cancellations must be notified in writing and sent by fax, paper mail or e-mail to Andalucia Travel S.A. (see information above)

Before September 15th, 2009: 50 € will be withheld.
After September 15th, 2009: no refund.