Registration Form

Conference Delegate:

first name: family name:*

Affiliation:

Mailing address:*

Contact:

email address:
phone/fax:

Accompanying Person(s):

Name: age:

(not participating in the

Name: age:

scientific program)

Name: age:

Registration Fees:

Conference
delegates:

The following fees include the welcome reception, the conference dinner and the excursion. The fees for the conference delegates also include admission to all presentations and workshops.
by 30 May: € 215 (approx. US$ 185)
from 1 June: € 245 (approx. US$ 210)

Registration for accompanying person(s):

by 30 May: € 109 (approx. US$94)
from 1 June: € 129 (approx. US$ 111)

Excursion
Participation:

I and the person(s) accompanying me intend to participate in the following excursion on Thursday afternoon: Burgenland, Vienna or Wachau

1st choice:

2nd choice:

Cost included in the conference fee.

Conference Dinner:

I and the person(s) accompanying me need vegetarian dinners.

Payment:

I pay the total* of € (registration fees for all participating persons) by the following method:
(In case you do a money transfer or send a cheque, please make sure that it is free of charge for the recipient.)

I transfer the designated amount to the Austrian bank account nummber 5230404 at "Raiffeisenbank Hagenberg, Raiffeisenplatz 1, A-4232 Hagenberg" (bank nummber 34460, SWIFT Code RZ00AT2L460)

I send a cheque to the following address, made payable to "ACDCA, VISIT-ME-2002": "VISIT-ME-2002, ACDCA, c/o B Kutzler, Hasnerstraße 9/10, A-4020 Linz, Austria"

I pay by credit card (check or circle): MASTERCARD VISA
Credit card number: expiration date:
(You may wish to fax the credit card data to us for security reasons. Please see the PDF-version of this form.)