Forensic Medicine 2012

The Nordic Conference on Forensic Medicine

13 - 16 June 2012, Aarhus, Denmark

Registration form

First name

Last name

Title

Institution / Company

Department

Address

Postal code

City

Country

Phone

Mobile

E-mail

Accompanying person

Vegetarian

Vegan

Registration fee

Paid after 16 April 2012

Participant - incl dinner

DKK 4400

One day participant - Thursday 14 June

DKK 1800

One day participant - Friday 15 June incl. Dinner

DKK 2600

One day participant - Friday 15 June excl. Dinner

DKK 1800

Accompanying person

DKK 1400

(Including Get-together, Opening ceremoni and conference dinner)

Workshop
Wednesday June 13 2012 at 11:00-13:30 - FULLY BOOKED

Wednesday June 13 2012 at 14:30-17:00

Disaster Victim Identification

I would like to participate in one workshop - DKK 650

Social Programme

Registration and welcome reception at The City Hall on Wednesday 13 June 2012 at 18:00

Visit in The Old Town (dinner included) - Thursday 14 June at 19:00 - DKK 350

I would like to participate in the conference dinner on Friday 15 June 2012 - incl in the registration fee

Total

DKK

Payment

Transferred to ”Forensic Medicine 2012”, c/o KongresKompagniet, S.W.I.F.T. DABADKKK, account No. 3643 3632584598, Danske Bank, Holmens Kanal 2-12, DK-1092 Copenhagen K, Denmark. PLEASE state name and “Forensic Medicine 2012”. IBAN: DK33 3000 3632 5845 98

By credit card (please have your credit card ready for online payment)

Electronic invoice (for Danish participants only).

Electronic invoice ( only for danish participants)

EAN No

EAN personreference

EAN Kontostreg

Accommodation

To obtain the stated room prices you must book through the conference secretariat KongresKompagniet by filling in and submitting this form.

I have arranged my own accommodation

Radisson BLU Scandinavia Hotel - single room - DKK 1395

Radisson BLU Scandinavia Hotel - double room - DKK 1395

Hotel Cab Inn - Captain - single room - DKK 745

Hotel Cab Inn - Captain - double room - DKK 925

Hotel Cab Inn - Commodore - single room - DKK 645

Hotel Cab Inn - Commodore - double room - DKK 825

Payment directly to the hotel upon departure. All room prices are per night per room and includes VAT, service charges and breakfast.

Arrival

Departure

I wish to share with

Special request

Cancellation and refund
Cancellation must be made in writing. In case of cancellation no later than 9 May 2012, the full amount less a cancellation fee of DKK 500 will be refunded. In case of cancellation after 9 May 2012, no refund will be made.

Annullering og refusion
Annullering skal ske skriftligt. Ved annullering før 9. maj 2012 vil det fulde beløb fratrukket et annulleringsgebyr på DKK 500 blive refunderet. Efter 9. maj er der ikke mulighed for refusion.

The registration form is sent to:
KongresKompagniet – Nordhavnsgade 4 – DK-8000 Aarhus C - CVR-nr: 3216 1588
Phone: +45 8629 6960 – Fax: +45 8629 6980
E-mail: forensic2012@kongreskompagniet.dk