ECVO Annual Scientific Meeting
23 – 26 May 2019 in Antwerp, Belgium

Registration Form

Conference Office:
CSM, Congress & Seminar Management
Industriestr. 35
82194 Groebenzell / Munich
info@csm-congress.de
+49 (0)8142-57 01 83
+49 (0)8142-5 47 35
www.csm-congress.de, Imprint

All data will be transferred through a secure connection (SSL)
 
Please let us know if the invoice recipient is
A private person NOT having a VAT number
An entrepreneur, a company or an institution having a VAT number (activated for intra-European purchases)

Remarks on the confirmation of payment
*Required fields

I am happy to receive information from the exhibiting & sponsoring companies via e-mail.
I prefer vegetarian food (lunches and conference dinner).

Continuing Education “Genetic Diseases”, Thursday, 23 May, 09:00h – 15:30h Registration and Payment Total
until 12 April 2019 from 13 April 2019
CE Day (I am also registering for the Main Programme) 155,00 EUR 180,00 EUR
CE Day only (I am not registering for the Main Programme) 240,00 EUR 265,00 EUR
Main Programme, Friday and Saturday, 24 – 25 May
Regular Registration
ECVO ACVO AiCVO ECVO-recognised Eye Scheme Examiner
480,00 EUR 530,00 EUR
Resident / Intern / Student
(Please have your confirmation ready to upload the document after you have filled in the registration form)
265,00 EUR 285,00 EUR
I will attend the Residents’ meeting on Saturday, 25 May from 12:00h – 14:00h
MasterClass “Genetic Diseases”, Sunday, 26 May
MasterClass (including seated lunch) 8:00h – 16:00h 160,00 EUR 185,00 EUR
Credit for Members of ECVO Committee(s)
Committee reimbursement fee

I am attending the following Committee Meeting(s)
On Wednesday, 22 May 2019
Executive Committee Meeting (09:00-14:00)
Hereditary Eye Diseases Committee Meeting (15:00-18:00)
Communication Committee Meeting (15:00-18:00)
Credentials Committee Meeting (15:00-18:00)
Education & Residency Committee Meeting (15:00-18:00)
Planning Committee Meeting (15:00-18:00)
Re-evaluation Committee Meeting (15:00-18:00)
Scientific Committee Meeting (15:00-18:00)
Credit 200 EUR
Social Events
Welcome Reception at the Diamond Museum DIVA
(Thursday, 23 May, 18:30h – 20:00h)
ticket(s) x 15 EUR
(incl. drinks & snacks)
Conference Dinner at Horta, Art Nouveau Hall
(Friday, 24 May, 19:30h)
ticket(s) x 85 EUR
(incl. dinner & wine, dance)
Payment
Total amount of your registration
Total
All prices include 21% Belgian VAT.
All prices are quoted in Euro.
Your registration will be confirmed by e-mail after the receipt of payment.

Credit Card Number
Expiration Date /
Card Verification No.
Cardholder's Name

Please transfer the total amount within 14 days to the following account of the conference office CSM, which acts on behalf of the organizer:
CSM, C. Schroettenhammer
Bank: HypoVereinsbank Muenchen
IBAN: DE09 7002 0270 1720 3428 00, BIC/SWIFT: HYV EDE MMX XX
Please remit your payment in EUR.
All bank fees must be covered by the sender.
Please indicate the name of the participant and the reference code 'ECVO Antwerp'.

Terms of Registration
All conference cancellations must be made in writing to the congress office CSM.
Cancellations received by 25 March 2019 are entitled to a full refund, less a handling fee of 60 Euro.
Cancellations received by 12 April 2019 are entitled to a 50% refund. No refunds can be made after 12 April 2019.

I have read the conditions of registration including the data protection notice, which I hereby accept.


Conference Organizer: European College of Veterinary Ophthalmologists (ECVO), www.ecvo.org