6th Congress of the European Society for Analytical Cellular Pathology
Heidelberg, Apr.7-11, 1999

Registration Form

Please print, complete legibly and mail to:

Drs.K.J.Hutter,M.Stöhr, 6thESACP Congress Office, DKFZ
Im Neuenheimer Feld 280, D-69120 Heidelberg, Germany
Tel: +49/6221/423208, Fax: +49/6221/422652, E-mail: esacp99@dkfz-heidelberg.de

back to: 6thESACP Congress Forms

Name: __________________________________________ First Name: _____________________________________

Institution _______________________________________________________________________________________

Street: ________________________________ ZIP Code: _______________ City:____________________________

Country: _______________________ Phone:(+country/area code) ___________________ Fax:__________________

E-mail _________________________________________________


  • Fees:
  • payment received
    before Feb.15
    payment received
    after Feb.15

    your balance

  • - ESACP members
  • - non ESACP members
  • - students (valid immatriculation/student card)
  • - tutorials (by Internet registration in Jan.1999 *)
  • - banquet ticket (lim.to 300, not incl.in registr.fee)
  • Total Registration Fee:


  • 550DM
    720DM
    500DM
    180DM
    50DM

    630DM
    800DM
    580DM
    180DM
    50DM

    ______
    ______
    ______
    (on site paym.)
    _____
    _____

    *) http://www.dkfz.de/esacp99/tutorial.html


  • Methods of Payment:

  • 1.Bank Transfer ("Überweisung"/Euro-Transfer)
    Deutsche Bank, München-Großhadern, acc.nr: 571 548 702, bank nr. 700 700 10, please label to: "6thESACP Congress + your name" for correct booking


    2.Credit Card Payment
    ___ Master/Eurocard, ___ VISA, ___ AMEX, Card nr: _________________________

    valid until: _____________, name of card holder _____________________________

    city __________________, date: ______________, signature: __________________


    3.Cheques (please label to: "6thESACP Congress + your name" for correct booking)
    - Eurocheques are accepted, please send cheque together with this On-line Payment Form to Heidelberg
    - Overseas cheques: please use credit card to lower banking costs


    Last Update: Jan.14,1999