Skin Summer SCHOOL 2014 3rd edition

Skin Summer SCHOOL 2014
3rd edition
“Quality requirements for raw materials and cosmetic products”
University of Pavia
June 23-25, 2014
REGISTRATION FORM
Deadline for reduced registration: May 30, 2014
Participants are requested to send the full payment of the conference fee together with the registration
form, enclosing a copy of the bank transfers by e-mail [email protected] o by fax +39
(0)382 304892. Payment should be made in euros.
Personal Information
Title(Prof/Dr/Mr/Mrs/Miss)
Name*
Surname*
Company/Institution/University*
Faculty
Address
Postal code
Country
e-mail*
Telephone N°
*Mandatory fields
City*
Accommodation details
Accommodation is included in the fee (except for students) and will be provided for the nights June 2324.
If you do not need accommodation, please select NO ACCOMMODATION (no discounts will be made)
Limited availability of rooms. First-come first-served basis will be followed.
□ no Accommodation
□ single room
□ double room
□ triple room
If your choice is double or triple room, please indicate the names of the person/s you want to share the
room with _________________________________________________________________________
Fees
REGULAR REGISTRATION
BEFORE
MAY 30TH
AFTER
MAY 30TH
Post Degree STUDENTS*
□ 580,00 €
□ 480,00 €
330 € registration fee
+
250 € conference services
230 € registration fee
+
250 € conference services
□ 700,00 €
□ 550,00 €
450 € registration fee
+
250 € conference services
300 € registration fee
+
250 € conference services
UNIVERSITY
STUDENTS*
□ 150 €
Access only to lessons
Fees include: access to all lessons, conference kit, welcome reception June 23, dinner buffet June 24, lunch
buffet June 23-24, coffee breaks, accommodation June 23-24, Gala dinner.
Student fee include only access to all lessons.
*please send a proof of your status by e-mail or fax to the Secretariat
Payment
Participants are requested to send the full payment, reading carefully the instructions below.
In order to register for the Skin Summer School 2014, two bank transfers are requested:
Registration fee (see the table)
BANK TRANSFER TO:
DIPARTIMENTO DI SCIENZE DEL FARMACO-UNIVERSITA' DI PAVIA
Bank Name: UBI - BANCA POPOLARE COMMERCIO E INDUSTRIA
Address of Bank: Corso Strada Nuova 61 - 27100 PAVIA - ITALIA
IBAN: IT19X0504811302000000046619
Reason for transfer: Registration Skin School 2014 + Surname
For international payment use Swift Code Number/Bic code: BLOPIT22
Student fee has to be paid entirely to Dipartimento di Scienze del Farmaco
Conference Services € 250,00 (VAT included)
BANK TRANSFER TO:
PRAGMA CONGRESSI SRL
Bank Name: INTESA SAN PAOLO
Address of Bank: Via XX Settembre - 27100 PAVIA - ITALIA
IBAN: IT25L0306911303100000003036
For international payment use Swift Code Number/Bic code: BCITITMM
A copy of the two bank transfers must be sent to the Secretariat by e-mail or fax
Registrations will be confirmed only upon receipt of the two bank transfers.
Invoicing details
Invoicing details must be filled in order to receive the invoice
Heading of the invoice
Address
Postal code
City
Country
VAT NUMBER (for invoices to Companies or Universities)
FISCAL CODE (for invoices to Italian citizens)
Date and place of birth (for invoices to persons)
E-mail
CANCELLATIONS AND REFUND POLICIES
All cancellations should be made in written form and sent to the Conference Secretariat at least 15 days before the
Conference. All refunds are subject to € 50,00 processing fee. Refunds will be made after the end of the Conference by
bank transfer. After June 8 the registration fee is not refundable, but substitutions are acceptable.
Date__________________________
_____________________
Contacts:
Pragma Congressi
Marta Daffara
Tel. +39 (0)382 309579
Fax + 39(0)382 304892
e-mail: [email protected]
Signature_________________________

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