26th Scientific Meeting, a joint meeting BSRM - DSRM
Antwerp, 25-26 November 2011
Personal details (please do not mix your working address and private address)
 
Family / Last name *
First Name *
Title*
Institute
Department
Street and number *
Postal code and city *
Country *
E-mail *
Telephone
Fax
Date of birth
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Registration part (for paid up BSRM or DSRM members only)
 
  Before 1 November
Meeting with hotel accommodation and dinner  
1 person: scientific meeting + single room + dinner 235 EUR
2 persons: scientific meeting + double room + dinner 185 EUR PER PERSON
Name of person with whom you will share a room
Meeting without hotel accommodation
 
Scientific meeting + dinner 100 EUR  
Scientific meeting only 50 EUR  
Accompanying person    
Dinner only 50 EUR  
Dinner + hotel accommodation 95 EUR  
Name of your accompanying person with whom you will share the room  
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Invoice details
Title + First name + Last name
Institute
Department
Street and number
Postal code and city
Country
Vat N°
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Payment policy
Full payment has to be made to the BSRM account 310-1263178-33 with reference:“Name + 26th Scientific Meeting”.
IBAN number: BE79 3101 2631 7833 • BIC: BBRUBEBB • Bank: ING. Upon receipt of your payment, your room will be booked and guaranteed and you will receive a confirmation. After 1 November rooms will be booked upon availibility in the hotel. All extras during your stay in the hotel such as minibar, telephone charges, room service, other bar costs, etc must be paid directly to the hotel when checking out.
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Cancellation policy
Your payment will be refunded provided a written cancellation is received by the BSRM Central Office before 30 September 2011. 70% of your payment will be refunded if a written cancellation is received after 30 September and before 31 October 2011. Please note that there will be no refund for the cancellations received after 1 November 2011.
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The details of the previous meetings can be found under Archives