12th Eurasia Conference on Chemical Sciences EuAsC2S-12

Corfu, Greece 16-21 April 2012

Registration Form

(PARTICIPANTS FROM DEVELOPING COUNTRIES)

Note: for the list of the developing countries ctrl+click here)

(use the TAB key to fill in the form)

First Name:
Last Name:
Occupation:
Institution:
Address:
Country:
Zip Code:	E-Mail:
Telephone:	Fax:

Scientific Contribution*
I shall primarily participate in the following session:

I intend to present a contribution:

Indicative title of the contribution:

*The final classification of the submitted abstracts will be made by the scientific committee.

Please read carefully the following information, mark the appropriate fields and calculate the total amount to be paid.

Proceed to page 2

REGISTRATION FEES

Before Jan 31st, 2012

After Jan 31st, 2012

1

Full Members (academic)*

230 €

330 €

2

Full Members (non academic)

330 €

430 €

3

Accompanying**

120 €

220 €

4

Students***

120 €

220 €

* IUPAC members and affiliates are eligible for 10% discount

** No separate form is required for accompanying persons

***25 scholarships (500 USD each) for students from developing countries will be available and will be awarded by the scientific committee based on the submitted abstract (5 offered by IUPAC)

The registration fees include: welcome reception, handbags, conference proceedings, transfer airport/hotel, coffee breaks, half day trip to Achillion Palace and a night with Corfu Municipal Orchestra at the Municipal Theatre

ADDITIONAL FEES (not obligatory):

5

Participation to the banquet of the conference at the traditional restaurant “Trypa” No of persons:

60 € per person

6

One day excursion: Corfu-Dodoni-Nekromantion-Ioannina-Corfu No of persons:

60 € per person

TOTAL amount to be paid (from 1-6): € (enter only digits in this field with no decimal or digit grouping symbols)

Receipt OR Invoice for your payment? (select only one)

Method of payment
VISA	MASTERCARD	Bank Transfer

Calculate the total amount for Registration and follow the instructions here (use ctrl+click for the web link) http://eurasia12.uoi.gr/payment.html
for payment via online secure transaction or via bank transfer.

Do not forget to save this document as an Ms Word document (yourname_reg.doc) and send it to eurasia12@conf.uoi.gr to complete your registration!

Registration will be confirmed by email from the organizing committee

1 | Page

Eurasia 12

Pre-registration form

Nikos

2011-07-11

UOI