Air2003 International Meeting on Alpha1-Antitrypsin Deficiency
Barcelona, June 11-13 2003.
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REGISTRATION FORM
REGISTRATION FORM


Please fill in this form and return it by fax together with your payment to the meeting secretariat.

NAME SURNAME
  ADDRESS TOWN/CITY
  PROVINCE/STATE POSTCODE COUNTRY
  INSTITUTION
  DR. / PROF. / PARAMEDICS
 

E-MAIL PHONE* FAX*
*Include Country, Area and City Codes.

REGISTRATION FEE AND DINNER
 

REGISTRATION FEE (VAT included)

DELEGATE 250 €  
ACCOMPANYING PERSON 150 € ACOMPANYING PERSON NAME.
PATIENTS'S GROUPS 85 €

The fee includes: attendance at the scientific sessions, congress-member documentation, attendance certificate, working lunches and coffees. Social dinner and Friday dinner are not included in fee.

DINNER

SOCIAL DINNER 80 € PERSONS
FRIDAY DINNER 65 € PERSONS

PAYMENT
  PAYMENT BY CREDIT CARD
 

As safety measure, if you wish to pay by credit card, we recomend you to fill and sign in the form bellow and send it to us by fax.

CREDIT CARD: (VISA, MASTERCARD) EXPIRY´S DATE:

 

TOTAL AMOUNT IN EUROS

 

SIGNATURE

 
 
  PAYMENT BY BANK TRANSFER
 

If you wish to pay by bank transfer, we please to send a copy by fax with the registration form.

The account number is:

SWIFF CODE BSAB ES 1
BANC DE SABADELL
0081 0381 99 0001101515

TECHNICAL SECRETARIAT:
 

BCM
C/ Balmes, 74 1º 1ª
08007 Barcelona
TEL 34 93 318 57 34
FAX 34 93 342 41 47
airmeeting@bcmedic.com
www.bcmedic.com/airmeeting