NOTE: This Registration Form is applicable only to participants who will attend exclusively the OLEICO+ workshop. Participation to OLIVEBIOTEQ conference activities on Nov. 4th are only covered by the registration fees mentioned below

Please fill in the form and send by e-mail or fax to the Conference Secretariat. Please keep in mind that after October 20th, registration will only be possible during the Conference.For information or clarifications, please contact Mrs Maria Bertaki.

Tel:+ 3028210 83443 Fax: +3028210 93963E-mail:

Personal information(Please type or print clearly in CAPITAL LETTERS)

Participation at conference as:

Participant or speakerInvited speaker

Please choose title:

ResearcherProfessorStudent Other:______

First (Given) name: Middle Initials Last (Family) name:

Name for badge:

Organization:

Postal address:

Postal code: City: Country:

Tel: (country code – area code – tel. no) Fax: (country code – area code – fax no)

E-mail address:

Special dietary requirements:(please tick your choices)

NoneVegetarianNo Pork Other:______

Summary of payment

Category / *Registration fee
Participant / 100 €
IAMAW member** / 75 €
Oleico+ team member / None
Invited Speaker / None

* For more information regarding what is included within each registration category, please visit the conference website.

** IAMAW members receive all OLIVEBIOTEQ 1-day registration material, except for the hard copy of the Proceedings. However, an electronic copy of the Proceedings (CD-ROM) is included.

Payment options

BANK DEPOSIT

Bank details:

Bank Name:AGRICULTURAL BANK OF GREECE

Bank Address:82 Tzanakaki str., 731 00, Chania, Crete

Account Number:377 04 003571 00

Account Name:NAGREF OLIVEBIOTEQ 2011

Branch Code:1141 CHANIA

IBAN Number:GR73 0431 1410 0037 7040 0357 100

SWIFT/BIC Code:ABGRGRAA

Note:All bank transfers should be exclusive of all bank charges. Please make sure to indicate participant's name on the bank transfer form. For submission, attach the bank transfer form to the registration form of the conference.

CREDIT CARD

Card type: VISA MasterCard

Name of card holder:
Card no.:
Expiry date: / (mm) / (yy)
CV-code: / (last 3 digits located on the back of the credit card)
I accept the charge of total amount: / €
Signature of card holder: / Date: / / /

An e-mail message confirming receipt of payment will be sent to the address provided above. Please have the confirmation message with you at the registration desk, in order to facilitate the registration process.

Important note:Any cancelation or change must be received and confirmed by the Conference Secretariat in official written notice via letter, fax or e-mail beforeSeptember 30thfor 85% refund of total payment. No refund will be granted after this date or for no-show. The refund will be processed one month after the symposium, less the applicable taxes and bank handling charges.

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