Iscrizioni

Family name:
First name:
Institution/Department:
Mailing Address:
Private Address Institute Address
Street:

Postal code:
City:
Country:
Phone:
Fax:
E-Mail:
* fill to receive a copy
Notes:

Invoice would be issued to the name indicated above, for any other heading please fill out the blank space 

Registration Fee

 

Congress
September 23

Course
September  24,25

Congress +
Course

Doctors

€ 120,00
included VAT

€ 180,00
included VAT

€ 270,00
included VAT

Residents

€ 90,00
included VAT

€ 120,00
included VAT

€ 180,00
included VAT

Welcome Reception

N.  Person:

x € 30,00 per person
included VAT

 

HOTEL RESERVATION

Hotel **** Deluxe
Hotel ****
Hotel ***

Arrival:

Departure:


Deposit to guarantee the first night’s reservation will be required

PAYMENT

The registration fee would be paid by    wire transfer      credit card
 
For payment by wire transfer:  Congress & Meeting Service srl  - Cassa di Risparmio di Pistoia e Pescia
IBAN:  IT 64 V 06260 70461 000 322817 C00 - SWITCH CODE:  CRFI  IT  3P
 
The wire transfer should be made free of any bank charges or banking commission. 
Please specify participant's name and "Avus Meeting" as reason of  payment
 
For payment by credit card: you need to send a Fax to +39 0572 913250
with the credit card number, expire date and your signature and authorization to charge the registration fee.
 
No confirmation will be sent until receipt of payment.