POSTGRADUATE SEMINAR ON LUNG CANCER

SAMOS 10-13 JUNE 2010

REGISTRATION FORM

IF YOU DON'T RECEIVE A CONFIRMATION WITHIN 3 WORKING DAYS SENT THE FORM AGAIN

SEX: MALE FEMALE

LAST NAME:

NAME:

INSTITUTE:

SPECIALTY:

ADDRESS :

CITY:

ΤΑΧ. ΚΩΔ:

COUNTRY:

FAX:

  E-MAIL:

Registration Fees

Participation Fee	120 Euro plus VAT 19%
Trainee	30 Euro plus VAT 19%

Sunday Scheduled tour to Ephesus

100 Euro (1 meal included)

All participants should have Passport or new Greek identity card.Cost is 100€ per person. 

Extra cost is 10€ for the Turkish port taxes and each participant should give this amount

(of 10€) and his/her passport or identity card directly to the Turkish authorities.

Please note that your passport or identity card will be kept in your entrance to Turkey

and you will take them back at your exit from the country.

Hotel Accommodation 

Hotel

Doryssa  Hotel	190 Euro/ Day  SGL or DBL
Doryssa Sea View	220 Euro/ Day  SGL or DBL
Doryssa Junior Suite	270 Euro/ Day SGL or DBL

Please Register  person(s) X =
for Accommodation room(s) X . =

SGL DBL DATE ARRIVAL  DATE DEPARTURE

SEA VIEW

for Ephesus Tour  person(s)X=
Grand Total =

The Accommodation package includes: 4nights in the hotel of your choice including Breakfast

Payment
All payments should be made to the Conference Secretariat.
You may choose from any of the following methods of payment):
BANK TRANSFER Ask for Details to the Secretariat
Deadline for this way of payment is June 1 2010
All payments must be forwarded in EURO and should be net of bank charges.
On all remittances the name of the sender should be clearly mentioned as well as the payment description (e.g. Mr. A. Sender, EURO 100, representing: 50 registration fees 50 hotel accommodation deposit for the LC Conference.
I have remitted the sum of EURO NET OF BANK CHARGES on in the name (remitter) through (name of Bank)
CREDIT CARD
(only VISA and MASTERCARD are accepted)
For security reasons, if you select this way of payment you will receive the authorization form from the Secretariat by email or by fax.
For any information concerning the registration please contact the Secretariat

FOR THE CONFIRMATION OF THE RESERVATION YOU HAVE TO TRANSFER THE FULL AMOUNT

CANCELLATIONS

Written Cancellation until 30 March 2010: full refund minus bank expenses and handling fee of 20 €

Written Cancellation after 30 March 2010: no refund