9th Symposium on New Developments in Clinical Pharmacy and Clinical Pharmacology - Registration

Please fill out one registration form per person.

Please complete the form below to register. All fields (except "Institution") are required.

Name*
Institution (if applicable)
Street*
City*
ZIP Code*
Country*
Phone*
E-mail*
 
Student/Intern*      yes     no
 
Friday, July 19th

In the afternoon and evening both programs will be together. Please choose either program A or B.

 
Social Program A (full day)
(Cable Car Ride, Mountain Walk (good shoes), Partnach Gorge, Lunch, Linderhof Castle, Bavarian Dinner)
EUR 125 or $ 165

    yes     no
Social Program B (full day)
(City Walk, Cable Car Ride, Mountain View, Lunch, Linderhof Castle, Bavarian Dinner)
EUR 125 or $ 165

    yes     no
Saturday, July 20th

 
Symposium (full day)
"New Developments in Clinical Pharmacy and Clinical Pharmacology" (incl. Festive Global Gators Dinner)
EUR 125 or $ 165 (regular)
EUR 60 or $ 80 (students, interns)

    yes     no
Festive Global Gators Dinner only
(spouses, partners, friends)
EUR 90 or $ 120		    yes     no

Please transfer EUR 0 or $ 0 to the following bank account:

Account number: 0101854836
Bank identifier: 30060601
BIC: DAAEDEDDXXX
IBAN: DE85300606010101854836
Account Holder: U. Koczian
Reference: GGM 2013 IBAN/Inhaber

You can also pay with PayPal:

1.   Go to http://paypal.com
2.   Create an account or log in to your existing account
3.   At the top click on "Send Money"
4.   Enter the email address linden-apotheke@augustakom.net
5.   Submit payment listed above