Registration Form

Professor Thomas Berninger
University Eye Hospital
Munich Mathildenstr.8
80336 Munich, Germany

Email: admin@visionscience2010.com

Tel. + 49-(0) 8142-45625 Fax. + 49-(0) 8142-45605

Name of registrant
Accompanying person(s)
Institution or company
Address line 1
Address line 2
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e-mail address
Special dietary requirements
Are you submitting an abstract?
Registration fee €150 (to 31st March) €200 (after 31st March)
Accompanying persons €150 (to 31st March) €200 (after 31st March)
Total fee €
Payment method Bank transfer
Account name Symposium 2010
Account number 0304038002
IBAN DE39300606010304038002
BIC DAAEDEDD
   
UK registrants may use the following account.  
(Fees in pounds sterling
£137.00 / £182.00)

Barclays Bank, 164-150 City Road, London, EC1V 2NL

 
Account name Arden symposium
Account code   60081906
Sort code  20 32 00
 

Signature (if faxing)

  
(Please complete, sign, and fax to Professor Berninger (+49 08142-45605))