Biology of Aging Laboratory
Department of Geriatrics
 

October 1-2, 2004, Geneva, Switzerland

Organizer : Irmgard Irminger-Finger

irmgard.irminger@medecine.unige.ch

 

  

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REGISTRATION FORM

Please print out and fax to the Conference Secretariat

Fax +41 (0)22 3467834

Or post to :

Geneva Foundation for Medical Education and Research
3, route de Florissant
1206 Geneva - Switzerland

Title (Prof., Dr, Mr, Ms)
Family name:
First Name:
Job Title:
Organization:
Address:
City:
Post/ZIP Code:
Country:
Tel:
Fax:
E-mail:
Special Dietary Requirements:

Registration fee @ EURO 250.00 
                                  EURO 100.00 reduced student fee

 

Payment
A bank transfer will be arranged upon receipt of invoice.
I enclose a check payable to YYYYYY
Please charge my

Card No:
Expiry Date:
Today's Date:
 
Name and address of card holder if different from above
Name:
Address:

I understand and agree to abide by the terms as set out in this brochure.

Signed:
Date:

Sponsoring/exhibition
I am interested in exhibiting opportunities or sponsoring the conference -
please contact me.
I do not wish to receive information from other organisations.

 

 

 
 


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Edited by Aldo Campana, September 3, 2008