Preparatory Course for The

Preparatory Course for the European Diploma in Transplantation Surgery Semmelweis University, Budapest, Hungary 28-29 May, 2009

REGISTRATION FORM Please complete with capital letters and send back by e-mail to [email protected] or by fax to + 36 1 223 2554 Deadline for hotel reservation: April 30, 2009

For your registration and accommodation, please use this form, and return it until the 30th of April 2009.

 Prof.  Dr.  Mr.  Mrs.  Ms. Family name: ………………………………………………… First name: ……………………………………………………….... Birthday (dd/mm/yy): …………………………………………………………………………………………………………………… Address: ………………………………………………………………………………………………………………………………………. City: …………………………..…………... Country: …………………………………………… Postal code: ……..………..... Institution: ………………………………………………………………………………………………………………………………….. Phone: ……………………….… Fax: …………………………….. E-mail: ………………………………….…………….………. Accompanying person’s name (for badge): …………………………………………………………………………………….. ………………………………………………………………………………………………………………………… …………………………. I need an invoice for the following name and address (leave empty if invoice is to be issued on your personal details as per above): ...... I. Delegate registration (prices include VAT):

Item Paid before Paid after April 30, 2009 April 30, 2009 Participant  100 EUR  150 EUR Accompanying person  80 EUR  100 EUR

Registration fee for congress participants includes: - access to the scientific program - congress bag with final program - reception on Thursday evening - lunch on Thursday and Friday, - coffee and soft drink tickets to be used during breaks.

Registration fee for accompanying person includes: - reception on Thursday evening - english speaking guided sight-seeing tour on Thursday.

Subtotal I: ………………… EUR

Congress bureau: Mis and Bos Ltd. H-1149 Budapest, Pillangó park 12/d Phone/Fax: + 36 1 223 2554, E-mail: [email protected] Website: www.misandbos.hu Preparatory Course for the European Diploma in Transplantation Surgery Semmelweis University, Budapest, Hungary 28-29 May, 2009

II. Hotel Reservation (prices include VAT): Terms of booking

Date of arrival: ……………..…………….. Date of departure: ………………..………..… Nr. of nights: …………..

Hotel Single room / Double room / night night Mercure Budapest Korona****, (10 minutes from the venue of the course on walk; H-1053  105 EUR  126 EUR Budapest, Kecskeméti u. 14.) Tulip Inn Budapest Hotel Millenium***+, (10  90 EUR  90 EUR minutes from the congress venue by public transportation; H-1089 Budapest, Üllői út 94-98.)

Accommodation requests after this date cannot be guaranteed. As we have limited availability in each hotel, reservation requests can be fulfilled on first come first served basis. Rates are intended per room, per night, 20 % VAT included. Only guaranteed reservation will be accepted; to guarantee the reservation, full payment should be done by bank transfer. Prices do not include bank charges. Please use one form per each registered guest. No any reservation will be accepted by phone.

Subtotal II: …………………. EUR

TOTAL cost …....…………… EUR (to be paid to UEMS)

Methode of payment: Bank transfer

Name of the Bank account: UEMS, Section of Surgery Bank: Berner Kantonalbank Bank address: CH-3001, Bern, Switzerland BIC CODE: KB BE CH 22 IBAN: CH 19 0079 0016 2596 86880 Transfer text: Preparatory Course Budapest

Please, send the copy of the bank transfer to Mis & Bos Ltd. FAX: +36 1 223 2554 E-mail: [email protected]

Congress bureau: Mis and Bos Ltd. H-1149 Budapest, Pillangó park 12/d Phone/Fax: + 36 1 223 2554, E-mail: [email protected] Website: www.misandbos.hu