Online Registration and Accommodation Form - V World Congress of Immunopathology & Respiratory Allergy V World Congress of Immunopathology & Respiratory Allergy

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Online Registration and Accommodation Form

* Family Name
* First Name
* Title
  Department
* Institution
* P.O. Box/Street Address
* ZIP Code
* City
* Country
* Phone
  (with area and city code)
  Fax
  (with area and city code)
* E-mail

* Select type of presentation: oral poster no preference

* Registration Fee
 Price/person (EURO)
Participants
Paid before June 30, 2009 550
Paid after June 30, 2009 650
Industry Representatives
Paid before June 30, 2009 650
Paid after June 30, 2009 750
WIPO Members
Paid before June 30, 2009 450
Paid after June 30, 2009 550
Attendees from Developing Countries
Paid before June 30, 2009 350
Paid after June 30, 2009
but before August 30, 2009		 400

Postgraduate Students, Nurses,
Accompanying persons

Paid before June 30, 2009 150
Paid before June 30, 2009 200


Subtotal 1 :  

Social Events
Number of persons
EURO
Opening Ceremony 0
Congress Banquet 90
Subtotal 2

See Discount Program for the list of countries eligible for this discount and other terms.

Hotel Reservation


Arrival: October, 2009       Departure: October, 2009
Please select >>   Pay only hotel deposit with the rest of the sum to be paid before September 20, 2009

  Pay accommodation in full right now
single double
Hotel deposit (EURO)
5 star 350
3 star hotel 180

The deposit (not booking fee!)
will be deducted from
your hotel bill

Number of nights:
Single room(EURO)Double room(EURO)
5 star 290 290
3 star 150 150

All above rates are per room per night including buffet
breakfast and are subject to a 20% VAT


Subtotal 3
Booking fee (per room)50
Subtotal 4


Congress Tours
Price/person (EURO)Number of personsEURO
Tel Aviv City Sightseeing Tour 60
Bethlem (half day tour) 90
Jerusalem, the capital of three religions (full day tour) 95
Nazareth – Galilee (full day tour) 95

Post-Congress Tours
Price/person (EURO)Number of personsEURO
Dead Sea – Red Sea (3 days/2 nights) 699
Tour to Jordan (Petra) (3 days/2 nights) 599

Subtotal 5 : 
Total:

Bank transfer:
Intermediary Bank:Raiffeisen Zentralbank Oesterreich AG,
AM Stadtpark 9, Vienna, Austria
Swift: RZBAATWW
Beneficiary Bank:ZAO "MOSSTROYEKONOMBANK",
78 Profsoyuznaya Str.., Moscow 117393, Russia.
Swift: MOSKRUMM
Beneficiary:INSTITUTE OF IMMUNOPHYSIOLOGY
Account:40703978773000300690

Please add Euro 30.00 as processing fee to Grand Total.
Visa     Eurocard / Mastercard

Charge my Credit Card No.             Exp. date

Card Holder Name       Passport No.       Valid through

Card type: CVV2 No.    or CVC2 No. (see your card reverse side)

Date    

A 5% administrative fee and a 3% charge fee will apply for all credit card payments.

I herewith confirm that I have read and am fully aware of the cancellation conditions stipulated in
   the Second Announcement.
I hereby authorize the Congress Secretariat (Institute, Euroline Intelservice, Congress Hotels, Secretariat)
to debit this credit card account for the total amount due.
I also consent to Congress Secretariat (Institute, Euroline Intelservice, Congress Hotels, Secretariat)
debiting or crediting my credit card account of any subsequent change(s) to the items booked.

Grand Total

Payment
Payment for registration fees, accommodation, tours and other services provided by Congress Secretariat is to be made before your arrival to Tel Aviv.

Cancellation Policy
Registered delegates and accompanying persons unable to attend the Congress will receive a full refund of their registration and accommodation fees less EURO 100 administration fee, provided that the Congress Secretariat on or before May 15, 2009 receives a written request. Cancellations received from May 15, 2009 to June 30, 2009 - 50% refund. No refunds will be issued for cancellations received after June 30, 2009. For any name change before June 30, 2009 an extra EURO 100 will be charged as a handling fee. After June 30, 2009 registration and accommodation fees are not transferable and name substitutions will not be allowed.
All approved refunds will be processed and issued 90 days after the Congress.