Online Registration ISPNO 2010

PERSONAL DATA
(Please print your name as it should appear on your badge)

	Mr. Ms.	Title:
First Name:*		Family Name:*
Institution:		Department:
Street:*		ZIP:
City:*		Country:*
Phone:*		Fax:
E-mail:*		Please note that all further correspondence will be addressed to this email. Please make sure to provide us with a working address.
* Required fields
I have submitted the abstract: (Please indicate the control number you received during submission - not a mandatory field)		2010-A--ISPNO

Please tick here if you do not wish your data to be forwarded to exhibiting companies on request.

REGISTRATION FEES (EURO)

***) Nurses, Psychologists, Social workers, Residents, PhD Students - please provide a copy of a confirmation by the head of department or an ID together with your registration by fax to +43 (0)1 407 8274

EDUCATIONAL COURSE Sunday, June 20, 2010

SOCIAL EVENTS

Welcome Reception
Sunday, June 20, 2010 No Yes

Note that only participants and registered accompanying persons may attend the social events.

LUNCH

Please note that lunch is only available for participants (not for accompanying persons).

Monday, June 21, 2010 No Yes
Tuesday, June 22, 2010 No Yes
Wednesday, June 23, 2010 No Yes
Thursday, June 24, 2010 No Yes
Vegetarian food required

PAYMENT MODALITIES

	Bank Transfer (free of charge for the beneficiary): “ISPNO 2010”, Account Number: 286 274 963 68 , at the Erste Bank, Bank Code 20111, SWIFT/BIC: GIBAATWW, IBAN AT17 20111 286 274 963 68- to avoid bank charges, please use the IBAN within the EU.
	Cheque: Bank cheques without charge to the beneficiary, should be payable to "ISPNO 2010" c/o Vienna Medical Academy, Alserstrasse 4, 1090 Vienna, Austria.
	Credit Card: Diners Club, MasterCard, VISA

Note
Please arrange bank transfers free of charge for the beneficiary. Any charges for banking fees or incorrect remittance of registration fees will be collected on site by the Congress Office.
Please make sure that the delegate's name (matching with the name on the registration form) is given on the bank transfer, as transfers bearing no name cannot be allocated.