Registration Form Registration Form

B: Terms of Payment

Payment must be made in Euros (€) to Purines 2000 (Fundación General UCM). Please indicate Purines 2000 (Fundación General UCM) and your name and affiliation on all money transfers

Amount to be paid: Euros (€)

Certified, guaranteed-payment check or bank draft, payable in a Spanish Bank. Add Euro 15.00 for foreign checks to cover bank charges (Please write participant's name on the check).

Charge to my credit cardVISAEuro/Master

Diner's ClubAmerican Express

Card No.:.

Expiration date:.

Bank-to-bank-transfer to Purines2000 (Fundación General UCM.)

Caja Madrid

Donoso Cortés 80, E-28015 Madrid, Spain

Account No.: 2038-1735-09-2000001492

All costs of transfer must be prepaid by the transmitter.

Please indicate participant's name, address and Purines 2000 (Fundación General UCM.) on the transfer and send a copy of your bank transfer with your Registration Form to the CONGRESS SECRETARIAT

I hereby confirm the registration and accept the conditions on page 17

Date:Signature:

Please return to:

Purines 2000

Congress Secretariat

Sección de Congresos y Exposiciones

Facultad de Medicina, Ciudad Universitaria

E-28040 Madrid, Spain

Fax: +(34) 91 394 1314

PLEASE, DO NOT FORGET TO MAKE A COPY OF THE REGISTRATION FORM FOR YOUR OWN RECORDS!
Purines 2000,Biochemical, Pharmacological and Clinical Perspectives

International Symposium of Nucleosides and Nucleotides

July 9-13, 2000 / Madrid, Spain

Should you require additional copies of this form you can download it from Purines 2000 Web pages

Registration Form

Participant (Please fill out in printed letters or check as appropiate)

Title: Mr. Mrs. Dr. Prof.

First Name / Initial / Last Name

Accompanying Person Name

Department/Laboratory

Institution

Street Address

Town/City / State
Postal Code / Country
Phone Number (country & area code) / Fax Number (country & area code)

e-mail

Invoice to / IC or VAT Number

Speaker:YesChairPerson:YesComputerYes

NoNoPresentationNo

A: Congress Registration

Registration fees (please check appropiate box)

Before February 29th / After February 29th
Regular participant / € 450.00 / € 500.00
Predoctoral Student* / € 200.00 / € 250.00
Nucleoside and Nucleotide Transport Workshop** /
€ 160.00 /
€ 200.00
Accompanying person*** / € 300.00 / € 350.00

Total Euros €

Reduced fee will apply only if both registration AND payment have been received at Congress Secretariat before February 29th.

* Student Registration must include a valid proof of current status as predoctoral students (working for a Ph.D.). For instance a letter from the Head of Department

** Applicable for those registering only for this workshop. Full registration already includes this workshop, additional registration is not necessary.

***Accompanying persons will receive a different documentation set. The fee covers social activities for accompanying persons and all regular participants social activities.

No Registration Form will be processed without its corresponding payment.

All fees are quoted in Euros (€) and include taxes. The registration fee includes:

  • Coffees (x4)
  • Lunches (x4)
  • Concert
  • Excursion to Segovia
  • Congress Banquet
  • Final Programme
  • Abstracts Book
  • Conference bag
  • Certificate of Attendance
  • Welcome Reception

Registration for the Nucleoside and Nucleobase Transport workshop includes a full set of documentation and coffee and meal for the workshop day only.

Social Activities for Accompanying Persons

Sightseeing tour around Madrid
(Monday, July 10, half day, morning)
Excursion to Toledo
(Tuesday, July 11, whole day, lunch included)
Excursion to Aranjuez/Chinchón
(Wednesday, July 12, half day, morning)
Excursion to El Escorial / Valle de los Caidos
(Thursday, July 13, half day, morning)

Regular participants may book on site for these excursions, conditioned to the availability of seats.

Cancellation Policies

Notification of cancellation must be made in writing and addressed to the Congress Secretariat. No other means of cancellation will be considered. Cancellations will be charged a fee according to:

before April 30th,, 200015%

May 1st /June 15th, 200050%

After June 15th, 2000 no refund

Credit cannot be given for no-show, late arrival, unused services, unattended events or early termination of attendance. All refunds will be processed after the meeting.

(Please, print duplex in both sides of a single paper sheet)