Registration Form

[Please note that submission of the abstract is only possible after completion of registration and payment]

After you have filled out the registration form, please click on the "SUBMIT" button. You will be directed to the payment site (secured) where you have to option to pay by credit card or bank transfer. When the payment process is successful, you will receive a seperate e-mail from OGONE (our online payment service provider) and you will be guided back to the CVB 2011 website.
Finally, you will receive an e-mail from the CVB 2011 Organizing Comittee to confirm your registration and provide you with your unique order reference number.

Name

Title:
Last:
First:
Badge name:

Affiliation

Institution:
Department:
Position:
- other:

Address

Address 1:
Address 2:
City:
State or Province:
Postal/Zip code:
Country:
Phone
E-mail address:

Extra information

I will attent the Gala Dinner on Friday June 24th 2011
I am a member of IBBS

Prices

Academic participant (€ 745,00)
Industrial participant (€ 845,00)
(PhD)-Student* (€ 600,00)
* Registration form as (PhD)-Student must be accompanied by a copy of a valid student card or by a letter signed by the head or supervisor of department confirming the status. The letter should be e-mailed as a PDF-scan to: organizers@CVB2011.nl

Disclaimer

I certify that I have read the registration and cancellation policy and the disclaimer statements. I hereby consent to and agree to be bound by such restrictions and disclaimer and the payment of the according registration fee indicates that I have accepted these terms.