✃
29th CINP WORLD CONgRess
CINP – The International College of Neuropsychopharmacology
22–26 June 2014 • Vancouver, Canada
RegistRation FoRm
Please forward the completed form to:
Please complete using block letters or typewriter
Hanser & Co gmbH
Phone:
+49–40–670 88 20
PO Box 12 21
Fax:
+49–40–670 32 83
22882 Barsbütel, germany
email:
a. Personal Details
m
Ms
m
Mrs
m
Mr
m
Dr
m
Prof
Family name:
First name:
Institution /Department:
mailing address:
m
private address
m
institute address
street:
Postal code, City:
Country:
Phone:
Fax:
e-mail:
B. accompanying Person
m
Ms
m
Mrs
m
Mr
m
Dr
m
Prof
Family name:
First name:
For registered accompanying persons a 3 hours bus tour
'
Photographic Tour of Vancouver
'
is included.
Please mark with a cross if you want to participate.
q
22 June 2014, 14:00–17:00 [40]
q
23 June 2014, 09:30–12:30 [41]
C. Registration Fees
Registration and Payment received
until
5 February 2014
until
20 may 2014
after
20 may 2014
eUR
CINP Member
[20]
q
eUR 500 [21]
q
eUR 600 [22]
q
eUR 700 eUR
Non-Member
[23]
q
eUR 700 [24]
q
eUR 800 [25]
q
eUR 900 eUR
Young scientist *
[26]
q
eUR 300 [27]
q
eUR 350 [28]
q
eUR 400 eUR
Delegate from Developing Country **
[29]
q
eUR 200 [30]
q
eUR 220 [31]
q
eUR 240 eUR
student ***
[32]
q
eUR110 [33]
q
eUR130 [34]
q
eUR150 eUR
Accompanying Person
[35]
q
eUR 90 [35]
q
eUR 90 [35]
q
eUR 90 eUR
total
eUR
* Applicants must be under 35 years of age and a copy of passport or other government-issued ID must be forwarded along with the registration.
** A limited number of developing countries registrations are available. To be eligible, you must reside in one of the following countries, as classified
by the World Bank. List see page 27.
*** students aged less than 35 years who are studying for a degree including first degrees, PhD or MD but who have not yet obtained their degree. They
must supply a letter from their supervisor or laboratory head to support their application for this reduced fee.
324
324
for internal use only
for internal use only
