Registration Form

    Title: Prof / Dr / Mr / Ms :
    First and Surname :
    .....................................................................................


    Profession :
    .....................................................................................
    Company/Institution :
    .....................................................................................
    Address:
    .....................................................................................
    .....................................................................................
    .....................................................................................
    Post/Zip code : ................. Country : ............................
    Tel.:...............................................................................
    Fax :..............................................................................
    E-mail :..........................................................................


    Registration Form download

    Fax : +49 6103 77 1275
    Secretariat to Dr. K. Cussler, or Dr. A. Mergel

    Registration Fee


    The registration fee will be € 125,-- and includes entry to the scientific program, abstract book, lunch, coffee breaks and the congress reception.

    Conference account

    All payments should be made in EURO (€) payable to :
    Reference number and name
    Bank name : ABN-AMRO
    Address :Postbus 10,3720 AA Bilthoven, The Netherlands
    Bank swift code (BIC) : ABN-ANL2A
    IBAN : NL61ABNA0512219990
    Account Number : 51.22.19.990
    Account Name : Inzake HELP Humane Endpoints

    All bank charges must be paid by the participant. Please quote the name of the participant on every money transfer form.