Registration form

Thank you very much for your interest in the XIIth Humanitarian Congress.

To register for the event on 15-16 October 2010, please complete the following form.

Fields marked with an asterisk (*) are mandatory.

REGISTRATION DEADLINE: Thursday, 30th September 2010



Profession/category:*(please tick one)
 
 
 
 
 
 
 
 
Personal Data:*
/
Attendance:*  
 
 
Registration fee:*
  Standard fee:*
 
 
  Reduced fee:
 
 
How did you hear about the Humanitarian Congress?
(max. 200 characters)
 
Bitte teilen Sie uns mit, an welchen Panels Sie planen teilzunehmen:*
Freitag,15. Oktober
Samstag, 16. Oktober
Do you have any remarks?
(max. 200 characters)
 
 


Thank you for registering.

If you require any additional information on the registration process, please send us an email.

We look forward to welcoming you at the XIIth Humanitarian Congress.

 

Congress fees

Costs for participation at the XIIth Humanitarian Congress are as follows:

Standard fee:
1 day:   €45
2 days: €90

Reduced rate:**
1 day:  €25
2 day: €40

** The following people are eligible for the reduced rate: students; trainees; unemployed; employees of Médecins du Monde Germany (Munich office), Medair Germany, German Red Cross (Berlin office), the Berlin Chamber of Physicians and employees of MSF Germany (Berlin/Bonn office only). Proof of identity is required.

Payment should be made by electronic transfer to the following bank account:

Account holder:Ärzte ohne Grenzen Stiftung
Account number:729 00
Bank:Sparkasse Köln/Bonn
Bank code:370 501 98
IBANDE74 3705 0198 0000 0729 00
Swift Code:COLSDE33
Billing reference:   

Humanitarian Congress 2010, your name,
date of registration


Please note: your registration will expire if the participation fee is not received within two weeks of registration.

Ärzte ohne Grenzen Stiftung
18. und 19. November 2005, Kaiserin-Friedrich-Haus, Robert-Koch-Platz 7, 10115 Berlin