Registration Form

REGISTRATION FORM

Deadline Registration Form and Registration Fees: 31 August 1998

Please fill in the form and submit it online using the "Submit" button. Your data will then be sent to the Conference Secretariat by E-Mail. However, submitting the form can't be confirmed by our server, but we will inform you immediately upon arrival of your registration data.

Participant

	Mr Mrs
Family Name:		Institution:
First Name:		Street/P.O. Box:
Title:		City:
Telephone:		Zip Code:
Fax:		Country:
E-Mail:

Accompanying persons

accompanying person accompanying participant

Family Name: First Name: Title:

Registration Data

Arrival at Goettingen Railway Station to reach the bus transfer at
15.00 hours 17.00 hours

Invitation letter necessary?
yes no

Applying for TMR Grant?
yes no
If yes, please fill in the Application form for TMR Grant afterwards.

Registration Fee		DM		DM
	Early registration fee	850,00	Registration fee	940,00
Reduced rates (dbl. occupancy)	Early registration fee	745,00	Registration fee	835,00
Accompanying person	Accommodation	162,00
	Meals	162,00
persons Bus transfer		30,00 /person
persons to visit the Wartburg		145,00 /person
Total Amount to be paid:

Please pay the amount due via bank transfer. For more detailed information see Registration Information.

Remarks

Thank you very much for registering for the European Clostridia Conference 1998!