Dear Colleagues, Dear Friends

2st Congress of Southeast Europe Neurosurgical Society Hotel Bristol, Sarajevo, Bosnia-Herzegovina 22nd-25th October 2015

REGISTRATION FORM

Surname: Name: Title: Specialty: Institution: Address: Telephone Mobile phone: Fax: E - mail: Date of registration:

The completed form should be sent on e-mail [email protected]; [email protected] or fax number: +381.11.3160.862

Registration fee: Early (until 15thJune 2015) Late (after 15th June 2015) 150 € __ 200 € __ SeENS members - 50% discount on Congress 75 € __ fee EANS individual members - 50% discount on 75 € __ Congress fee One day registration 50 € __ PEDIATRIC NEUROSURGICAL ENDOSCOPY 100 € __ COURSE LIVE NEUROSURGERY OPERATION 150 € __ 1ST NEUROSURGERY NURSING SYMPOSIUM 30 € __ SEENS Membership for 2014 50 € __ RESIDENTS Free participation with signed confirmation paper from the head of the department about the residency *VAT is included Galla dinner per person: 50 € __ Spouse&Guest 50 € __ PAYMENT INSTRUCTIONS: Domestic currency payments are accepted by bank transfer to following data. Bank: Vojvođanska Banka ad, Novi Sad Acc: 355 – 1114559 – 41 Address: ARIA d.o.o., Dr Petra Markovića 12, 11080 Belgrade, Serbia

Foreign currency payments are accepted ONLY by bank transfer to following data.

Intermediary: DEUTDEFF (Deutsche Bank AG, Frankfurt) Account No/ SWIFT CODE: 936528900 VBUBRS22 (Vojvođanska banka AD Novi Sad, Trg Slobode 7, Address of the bank: Novi Sad , Filijala Beograd, Srbija)

Beneficiary Custtomer / IBAN No: RS35 3550 0000 0200 5668 34 ARIA DOO, Dr Petra Markovića 12, Address : Zemun - Beograd, Srbija ABSTRACT INSTRUCTION

Deadline for abstract submission: 1 st July 20 1 5

Abstracts should be submitted on the e-mail : [email protected] [email protected]

TITLE OF ABSTRACT:

*Author: Coauthor: Institution:

Abstract:

Introduction:

Material and Methods:

Results:

Conclusion:

Key words:

**Presentation preference: Oral, e-poster, video presentation

*Underline the name of the presenting author ** Underline your presentation preference

Congress Secretariat ARIA Conference & Events St. Dr Petra Markovića 12 11080 Zemun – Belgrade, Serbia Tel. +381.11.3160.625, 3731.536, 2196.530 Fax. +381.11.3160.862 office @ aria . co .rs; www . aria . co .rs