Online registration


Welcome to the online registration form for the
EMDS 2012 Conference


  • All fields marked (*) are mandatory and must be completed for administration purposes.
  • PLEASE NOTE online registration will be closed from Midnight on 22th August 2012.
Personal details

Family name: *
First name: *
E-Mail: *
Gender: * female male
Title:
Phone: Country - Region - Number

Hospital/ Institution: *
Address: *
Address 2:
City: *
Postcode: *
Country: *
Job Title:
Dietary Requirements:
NOTE: Cannot be guaranteed

Billing Address

Billing name:
Contact person:
Address:
City:
ZIP:
Country:
Phone:
E-mail:

Registration Early Bird Registration Fee
(until 31st May 2012) 		Registration Fee
(from 1st June 2012)

EMDS Member €260 €360
Non Member €310 €410
Student €210 €310
Hungarian students under 35 years is 25000 HUF

Accompanying person €50
Name, First name:
The fee for accompanying persons includes the Welcome Reception(01.09) and Grill party (02.09.)

Social event

03. 09. 2012 Hortobagy (Puszta program and dinner) € 20

Total amount in €: 0

Payment instructions (The total amount will be as follows): *
Bank Transfer to Remedicon Ltd.
Name of the bank: Raiffeisen Bank, Hungary
H-1054 Budapest, Akademia u. 6.
IBAN: HU70 1200 1008 0013 7553 0020 0002 SWIFT: UBRTHUHB
Credit card
(Please fill and send back the credit card authorization form) Form


EMDS Annual Meeting 1-3 September 2012, Debrecen, Hungary