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Registration
Form
SIETAR
Congress 2004 in Berlin
Please
return to:
SIETAR
Deutschland e.V., Postfach 31 04 16, D-68264 Mannheim - (
+49- 621/7179002 FAX: +49-
621/7179004
_____________________________________________________________________
Please
use capital letters
A. Participant
Name __________________________________
Surname _________________________________
Company _____________________________________________________________
Street __________________________________
P.O.Box __________________________________
Zip Code _______________
City _________________________________________________________
Country ____________________________________
E-Mail ____________________________________
Phone __________________________________
FAX _____________________________________
Please
tick off, if this is your private address: o
B.
Congress Fees
I am
member of SIETAR Germany o
SIETAR
Europa o or SIETAR ___________________
I am
not a SIETAR-member: ___ I would like to join SIETAR: SIETAR Germany o SIETAR Europe o
or SIETAR ________________
o SIETAR
Member o Student under 28/Pensioner (SIETAR
Members)
¡ Regular Fee (16.01. – 05.03.04) à 350,00 € O Regular Fee (16.01. – 05.03.04)à 150,00 €
¡ Late Fee (after 06.03.04) à 450,00 € O Late Fee (after 06.03.04) à 200,00 €
o NON-Member o Student under 28/Pensioner (NON-Member)
¡ Regular Fee (16.01. – 05.03.04) à 425,00 € O Regular Fee (16.01. – 05.03.04)à 175,00 €
¡ Late Fee (after 06.03.04) à 500,00 € O Late Fee (after 06.03.04) à 250,00 €
o Eastern
Europe National o Congress-Celebration Event (Dinner, Life Music & Dancing)
O
03.04.04 at 8 pm at the House of Cultures à
45,00 €
¡ Regular Fee (16.01. – 05.03.04) à 175,00 € including welcome drink,
international buffet, first bottles
of wine,
¡ Late Fee (after 06.03.04) à 250,00 € great Brazilian and
African dance music and a wonderful
atmosphere
including
16 % V.A.T congress-materials, lunch and drinks during the congress days (01.–
03.04.2004),
excluding
participation in pre-congress-workshops (31.03.2004) and post-congress- workshops
(04.04.2004)
C.
Pre-/Post-Congress-Workshop Fees
Title Arrangement/Name Date Price
€
Please
note that fees for Pre-/Post-Congress-Workshops do not cover congress participation.
D.
Payment
o Transfer to bank account Stuttgarter Volksbank AG
account no.: 224051016/bank code: 60090100/
IBAN: DE41600901000224051016 – BIC (SWIFT-Code): VOBADESSXXX
o Please charge my credit card (only for NON-EU-PARTICIPANTS)
O Eurocard / Mastercard O Visa à
no other cards!
Credit card No.
¨¨¨¨ ¨¨¨¨ ¨¨¨¨ ¨¨¨¨
Credit
card pin: (last 3 numbers on back of the card) ¨¨¨
Exp. Date ¨¨ ¨¨
Month/Year
Card Holder: ____________________________________________
Please
note that all bank charges have to be settled by you. If this is not done, we will need to send
you an subsequent invoice for the lost bank charges, which will create additional costs for you. Thank
you for your cooperation.
Date: Signature:
With my
signature on this registration form I accept these conditions.
Details
of registration
Payment
Bank transfer
Please remit the amount in Euro with your registration to:
Stuttgarter Volksbank, account no.: 224051016/bank code: 60090100/IBAN:
DE41600901000224051016 – BIC (SWIFT-Code): VOBADESSXXX
The participants will be charged for any bank transfer charges which might
be incurred.
Credit card
Please indicate on the registration form your credit card organisation,
credit card number,
expiry date and name of card holder.
The amount of the congress fee will be charged to your credit card at the
next possible
date.
Please note that all bank charges have to be settled by you. If this is
not done, we will
need to send you a subsequent invoice for the lost bank charges, which will create
additional costs for you. Thank you for your cooperation.
Signature
The signature on the application form is essential, otherwise your registration
cannot be
processed.
Confirmation
After receipt of the payment, we will confirm your registration. If you
register later than
March 1st, 2004, please present a copy of your bank remittance form at the Congress
Office.
Accommodation
SIETAR has pre-booked some hotels close to the congress site. Please make
all
arrangements with hotels personally. You can an download a list of pre-booked hotels from
the congress website.
Cancellations
Registered Congress participants
who cannot attend the Congress will receive a refund of the
Congress registration fees as follows:
Receipt of cancellation by February
15th, 2004
Receipt of cancellation by March
15th, 2004
Receipt of cancellation after
March 15th, 2004
Please take the cancellation
(with your name, address and registration-no.) to
registration@sietarcongress2004.de or FAX: +49-621/7179004. Any bank charges shall be
borne by the participants.
Liability
SIETAR Deutschland e.V. is not
liable for any losses/casualties, accidents or damages to
persons and objects, regardless of their origin. Oral arrangements require a written confirmation.
With the signature on the
registration form the participants accept the conditions
mentioned above.
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