ONLINE Registration

If you are a human and are seeing this field, please leave it blank.

Personal Information

* Required Field

First Name: *

Last Name: *

Company: *

EASL number:

ISPOR number:

Mobile: *

Fax:

Email: *

The confirmation will be sent via e-mail.

Address

(Billing Address)

Country: *

Postal Code: *

City: *

Address: *

Registration

Please choose from below, regarding to your status:

Early Bird (EB) OCTOBER 01, 2015 – APRIL 30, 2016
Late Registration (LR) MAY 01, 2016 –JUNE 23, 2016

EASL/ISPOR member*

EB 300 €
LR 400 €

non EASL / ISPOR member

EB 450 €
LR 550 €

Student / nurse **

EB: 130 €
LR: 150 €

MGT member

EB: 200 €
LR: 300 €

* Only ACTIVE EASL / ISPOR members are entitled to the EASL / ISPOR members’ registration fee.
** Under 35 at the time of the congress and in training. Proof of age and proof of nurse status is mandatory.

Accomodation

* The rates includes the accomodation for the marked dates with breakfast, lunch, dinner and taxes.

1. Single standard room 219 EURO/person/night

23. June
24. June

2. Double standard room 124.50 EURO/person/night

23. June
24. June

Requested roommate's data:

First Name:

Last Name:

Company name:

Mobile:

E-mail:

Cancellation/Refund Policy

If your hotel reservation and registration is cancelled until March 1, 2016, the deposit will be refunded (50% of your booking). If your reservation is cancelled after March 1, 2015, or if you arrive later or leave earlier than on the dates indicated on your reservation form, the total accommodation amount will be charged.

Payment Details

Total in €

Please invoice my organization

I will be sending a bank transfer to

Account Holder: MEDICONGRESS HUNGARY KFT.
Bank: RAIFFEISEN BANK
Swift Code: UBRTHUHB
IBAN: HU22-12020407-01471761-00100004