Please complete ALL necessary fields accordingly. Registrations with unverifiable/incomplete entries will be ignored.

First Name:
Last Name:
Affiliation/Title:
Organisation:
Mailing Address:


City:
ZIP Code:
Country:
Tel. Number:
FAX number:
E-mail address:

I wish to receive any subsequent information.

I plan to submit a paper:

Oral presentation
Poster presentation

  Authors:
  Title:
  In Topic / Symposium:
 



BEFORE April 1, 2004
AFTER April 1, 2004
General 500 Euro ()
Author 450 Euro (
)
Student 250 Euro (
)
General 550 Euro ()
Author 500 Euro (
)
Student 300 Euro (
)



(Applies ONLY to NON-residents of Hotel Rodos Palace. For the residents of Hotel Rodos Palace, lunches are included in the accommodation fee).

Days (1 lunch/day):
Lunch price: 18 Euros ()
Lunches Subtotal:



(Applies ONLY to accompanying persons. For the participants of the Conference, the banquet is included in the registration fee).

Banquet price per person: 44 Euros ()
Number of accompanying persons:
Banquet Subtotal:


Sum of Registration Fee & Lunches & Banquet = Euros (€)



Bank Transfer payable to the bank account number:
IBAN: GR25 0110 2260 0000 2265 0703 097
SWIFT CODE: ETHNGRAA

A copy of the Bank Transfer receipt must be sent to the Secretariat of ECCM11 (Fax No. ++30-2610-965223).

Credit Card (MasterCard, VISA)
(You will be contacted for credit card details)