IMUNE Bergen Online Registration Form

The Science of Self Regulation
1st to 4th May 2008

NB- this form is for ALL Conference Registration and hotel registration at the conference hotel (Scandic) ONLY- if you will be using a different hotel please book accommodation directly with the hotel using the website link- please do note this on the form below.

This form is designed for one person. If you are accompanied please fill up and submit one form for each person or contact Sue Rado (see contacts for details)

NOTE THAT OUR CARD PROCESSORS REQUIRES THAT ALL TRANSACTIONS ARE MADE IN £ (POUNDS STERLING) Other currencies are indicative and your actual statement may vary slightly from the values shown, depending on conversion rates at the time of transaction.
 
Your Name(s):
Address:
inc city & postal/zip code
Telephone: (INCLUDE Country and area codes)
E-mail:
E-mail validate:
Arrival Date: (if known)
Departure Date: (if known)
   
I am registering for

IMUNE Bergen Conference & Fiord Event

(Registrations from the 1st February 2008 onwards)
NOK 6250.00
$ 1150.00
€ 795.00
£ 570.00
I'd to go on the

Special Fjord Evening Cruise

(Select this if you have a partner etc. who is not attending the conference but does want to come on the cruise. DO NOT select this if you have selected the conference- the Fjord trip is included! )
NOK 790.00
$ 145.00
€ 100.00
£ 70.00
I'd like to register for a Clinical Assessment - booked before 28th February 2008
NOK 1185.00
$ 220.00
€ 150.00
£ 110.00
I'd like to register for a Clinical Assessment - booked After 1st March 2008
NOK 1580.00
$ 290.00
€ 200.00
£ 144.00
I'd like to include a

Conference proceedings DVD - Bergen

(SPECIAL RATE FOR CONFERENCE ATTENDEES ONLY)
NOK 395.00
$ 75.00
€ 50.00
£ 35.00
I'd like to include a

Conference proceedings DVD - St Marten 2007

(SPECIAL RATE FOR CONFERENCE ATTENDEES ONLY)
NOK 395.00
$ 75.00
€ 50.00
£ 35.00
Accommodation Option 1 at the conference hotel
I wish to book at the Scandic Conference Hotel, 30th to 4th May (arriving 30th April, departing 4th May)

Please check your flights to ensure that the accommodation dates will meet your travel plans.

The hotel part of the conference finishes at 4 pm and then is followed by the concluding event of the Fjord cruise at 5pm to 11pm on Sunday the 4th.

The conference is on the 1st, 2nd, 3rd, 4th May. We have rooms booked on the 30th, 1st, 2nd, 3rd, 4th May. This allows you to arrive on Wednesday the 30th of April, be part of the cruise on Sunday the 4th of May and leave during Monday the 5th of May.
     
I'd like a Double room PRICES ARE PER PERSON, PERNIGHT
NOK 695.00
$ 129.00
€ 88.00
£ 63.00
I'd like a Single room PRICES ARE PER NIGHT
NOK 1190.00
$ 220.00
€ 151.00
£ 108.00
Enter number of nights You MUST make an entry here - if you have accommodation elsewhere please enter 0. The standard is 5 nights. If you want extra nights increase the number and indicate extra dates below
Extra nights I want hotel accommodation for extra nights.

on these dates >>

If you have booked a double room and we can find someone who is also staying for the extra nights then the double room rate will apply. If this is not possible a single room rate will apply.
I have a room mate Please help me find a room mate
Accommodation Option 2 own hotel arrangements
     
  I'll be making my own arrangements  
  I have a room mate  
  Please help me find a room mate  
 
Options for non attendees
  
     
I'd like to include a

Conference proceedings DVD- Bergen -
(SPECIAL RATE FOR CONFERENCE ATTENDEES ONLY)
NOK 1185.00
$ 220.00
€ 150.00
£ 108.00
I'd like to include a

Conference proceedings DVD - St Marten 2007

(SPECIAL RATE FOR CONFERENCE ATTENDEES ONLY)
NOK 1185.00
$ 220.00
€ 150.00
£ 108.00