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Registration Form
Click here for terms and conditions
Fax to: +44 (0) 1865 843958
Mail to: Janet Seabrook, Elsevier, The Boulevard, Langford Lane, Kidlington, Oxford OX5 1GB, UK
Please register me for the First World Congress of Oral Oncology
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Presenters should provide their abstract reference number in order to ensure that their material is included in the final program and abstract book
Ref:
Registration Rate
IAOO Fellow €500
Non-member of the IAOO: €550
Student, Nurse, Resident: €200
Late booking surcharge for all registrations received after 1 April 2007: €100
Please book me _____ tickets for the optional Conference Dinner @ €50.00 + VAT @ 19% = €59.50.
Further Information
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DECLARATION (Please note that unsigned forms cannot be accepted)
I have read and agree to abide by the payment and cancellation terms, and I understand that this form confirms my conference booking. I accept that from now on charges will be imposed for cancelled registrations, and that up to the full registration fee will be payable if I am unable to attend the conference for any reason.
Signed:__________________________________________________________________
Date:__________/__________/__________
Data Protection Notice: The personal information that you provide on this form will be used by Elsevier Limited, The Boulevard, Langford Lane, Kidlington, Oxford, OX5 1GB, UK, conferenceinfo@elsevier.com and, with your consent, may be transferred to and processed by affiliated Elsevier group companies outside of the European Economic Area, including the United States, to process your registration, and, with your permission, may be used by us and affiliated and non-affiliated third parties for marketing purposes. We respect your privacy and do not rent, sell or disclose your personal information to any non-affiliated third party without our consent.
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| Last Updated 20 November 2006 |