REGISTRATION FORM

SD-MED REGISTRATION FORM

PERSONAL DATA

Title:

First Name: *

Last Name: *

Badge Name:

Company / Institution: *

Departement:

Division:

Position: *

CONTACT INFORMATION

Address: *

City: *

Postal Code / Zip: *

Province / State: *

Country: *

E-mail: *

Phone: *

Fax: *

GUEST

Mr. / Mrs:

First Name:

Last Name:

REGISTRATION

Registration Fee:

Guest's Fee:

Number of Guest Persons:

CONFERENCE DINNER

Participation fee:

Number of Persons:

PAYMENT:

Payment should be made after reception of  confirmation of your registration and your ID number and in advance of the Conference by bank transfer. No on site registrations will  be accepted. Please note that the number of places are limited.

Please deposit the total amount due to the order of :
« PANTEION UNIVERSITY RESEARCH COMMITTEE »
address : 136  Syngrou Ave., Kallithea 176 71 Athens- Greece
at
ALPHA BANK, branch (149), SYNGROU-FIX
80-88, Syngrou Ave., 117 41  Athens, Greece
Account Number : 149-00-2320-002905
IBAN A/C: GR 60 0140 1490 1490 0232 0002 905 
Swift Code: CRBAGRAAXXX

Payment should be made in Euro. Please make sure that you indicate "SB08MED - Registration" and your name and company or institution on all money transfers.

Please send, if possible, a copy of the stamped bank deposit receipt via fax at +30 210 9235310 or by e-mail at congress@sd-med.org , to the attention of SD-Med Secretariat

CANCELLATION POLICY 
All conference cancellations received in written by 15 December 2007 will receive a full refund less a 50 Euro administrative fee. No refunds will be made after 15 December 2007. No refunds are given for no-shows.

CONFIRMATION
Confirmation of registration will be sent to all delegates whose payment has been received, by e-mail.

09 Meeting

REGISTRATION FORM

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