Science for the Environment 2011

5 - 6 October at Aarhus University, Denmark

Registration form

First name *

Last name *

Title

Institution / Company *

Department

Address *

Postal code *

City *

Country *

Phone *

Mobile

E-mail *

Vegetarian

Vegan

Registration fee *

Registration paid after 1 August 2011

Participant incl. dinner

DKK 2850 (EUR 380)

Participant excl. dinner

DKK 2400 (EUR 320)

Student incl. dinner

DKK 1275 (EUR 170)

One-day-fee 5 October

DKK 1500 (EUR 200)

One-day-fee 6 October

DKK 1500 (EUR 200)

I am one day participant on 5 October (or accompanying person) and I would like to participate in the conference dinner - DKK 480 (65 EUR)

No of persons

Job position

Please tick off all relevant boxes

Research

Consultancy

Administration

Other

(Please state position)

Working area
Please tick off all relevant boxes

Water

Soil, forests and agriculture

Harzards and risks

Biodiversity and land use

Marine

Atmosphere

Environmental technologies/ geoinformation

Climate change

Integrated analysis/ modelling

Other

(Please state area)

Total

DKK

Payment *

By cheque in DKK, made payable to : “STE”, c/o KongresKompagniet, Nordhavnsgade 4, DK-8000 Aarhus C, Denmark drawn on: Danske Bank, 2 –12 Holmens Kanal, DK-1092 Copenhagen K., Denmark

Transferred to ”STE”, 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 “STE”. IBAN: DK33 3000 3632 5845 98

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

Electronic invoice (for Danish participants only).

EAN No

EAN personreference

EAN Kontostreg

Hotel 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

Hotel Cab Inn - commodore - single room - DKK 635 (EUR 85)

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

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