PARTICIPANT REGISTRATION FORM (4th EPSMSO)

(for those who want only to attend the works of the Conference)

Participant's details

Title:

Last Name:

First name:

Gender:

Position:

Organisation:

Address:

Country:

Phone:

Fax:

E-mail:

Registration Fee

Registration before 15 May, 2011	Full Registration	300 EUR
	Postgraduate Students⁽¹⁾	100 EUR
	Undergraduate Students⁽²⁾	0 EUR
Registration after 15 May, 2011	Full Registration	350 EUR
	Postgraduate Students⁽¹⁾	150 EUR
	Undergraduate Students⁽²⁾	0 EUR
Options	Proceedings on paper (including the cost of Air-Mail)	80 EUR

Total Remittance (in Euros):

Full Registration includes: Program/Abstract Book, USB stick with Proceedings, Coffee Breaks, Lunches, Banquet.

⁽¹⁾ Postgraduate Students registration includes: Program/Abstract Book, USB stick with Proceedings, Coffee Breaks.

⁽²⁾ Undergraduate Students Registration includes: Session attendance and Conference badge. (Please, send
a copy of your student ID by e-mail).

Form of Payment

I have ordered a Bank Transfer** (copy of the bank transfer should be sent by e-mail)***

Payment by Western Union** (copy of the bank transfer should be sent by e-mail)***

Payment Date:

Sender Name:

** Bank/transfer costs are paid by the registrant
*** Please indicate the name of the participant and the code "4th IC-EPSMSO Conference" and email to:
info2011 @ epsmso.gr

Receiving bank details:

Bank name and address:	NATIONAL BANK OF GREECE Galatsi Branch, Athens, Greece
Bank account number:	122/380098-93
Currency code	EURO
Code BIC (SWIFT address) (obligatory):	ETHNGRAA
COS IBAN:	GR7401101220000012238009893
Name of beneficiary:	PROFESSOR DEMOS TSAHALIS 4th IC-EPSMSO

Cancellation
All cancellation must be made in writing to the Conference Secretariat. For Cancellation received by 31 May, 2011
a refund of 80% will be granted. No refunds will be made for cancellations after that date.

Your registration will be confirmed after the receipt of payment (please don't forget to keep a copy for your file)

The conditions of this registration are hereby fully accepted.