Eighth Workshop on Partnering for
Rare Disease Therapy Development
Copenhagen, 18-19 October 2007
Online Registration

PERSONAL DATA
  Mr. Ms. Title:
First Name:* Family Name:*
Institution:* Department:
Street:* ZIP/Postal Code:
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 AM:
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REGISTRATION FEES (EURO)
Patients or Patient Representatives EUR 100.00
Students EUR 100.00
Scientist non-industry EUR 150.00
Scientist or attendee – government representatives EUR 150.00
Industry* – EPPOSI Members EUR 750.00
Industry* – non-EPPOSI members EUR 900.00
Other EUR 150.00

* Industry means healthcare companies with products sold or being developed
LUNCHES
Please enter the appropriate number of persons in the textbox.

Thursday, October 18, 2007   
Friday, October 19, 2007   
Vegetarian food required
EVENING EVENTS
Please enter the appropriate number of persons in the textbox.

Dinner on Thursday, October 18, 2007No extra fee, but registration is necessary

Please note that a limited number of places is available for the dinner of October 18. Registrations will be handled on a first-come first-served basis.
SPECIAL REQUIREMENTS
Please indicate any comment or needs for a successful participation in the congress:
PAYMENT MODALITIES
Bank transfer free of charge for the beneficiary to the Congress Bank Account: "EPPOSI Workshop", Beneficiary: "Epposi Workshop c/o VMA, Alserstrasse 4, 1090 Vienna, Austria"
IBAN: AT 26 20111 280 365 803 54, SWIFT/BIC: GIBAATWW.
Account No. 280 365 803 54, Bank/Routing code: 20111, at the “Erste Bank”, Alserstrasse 23, 1080 Vienna, Austria
Credit card: We accept: Diners Club, Mastercard, Visa
Note
Please make 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.