REGISTRATION FORM

International Mastitis Conference: From Science to Practice
30 September - 2 October 2008
The Hague, The Netherlands

The preferred method of registration is via this webiste. Registration is also possible by fax. You can download, print and fill out the PDF version of the registration form.

Personal Information

Type of registration *	Delegate Speaker Sponsor Scientific Committee
Prefix*	Prof. Dr. Mr. Ms. other,
Firstname:*
Initials:*
Lastname:*
Badge Name:
Title(s):
Organization / Company (max. 30 characters):*
Department (max. 30 characters):
Position:
Address:*
Postal Code:*
City:*
Country:*
Business Phone: (including country code)
Business Fax: (including country code)
Mobile Phone: (including country code)
E-mail address:*
Dietary restrictions:

Conference Registration

Please make selection below. The lower fees are applicable only when registration form and payment are received on or before 1 July 2008. All prices are quoted in Euros and including 19% VAT.

A. Registration Fee

Early Bird (registration before/on 1 July 2008)
	Full Registration € 250,00
	(Under)graduate Student*€ 150,00
	* (Under)graduate students must provide valid proof of full-time status, issued by their educational institution, with their registration form
Standard (registration after 1 July 2008)
	Full Registration € 350,00
	(Under)graduate Student* € 250,00
	* (Under)graduate students must provide valid proof of full-time status, issued by their educational institution, with their registration form

B. Social Program

Welcome Reception, 30 Sept. 2008 (included)	Amount of Persons
Conference Dinner, 1 Oct. 2008 (€ 85,00 p.p.)	Amount of Persons

Payment Information
Please select the preferred method of payment (to be used for all registration items). All payments must be made in Euros (EUR) and the name of the participant and registration number should be stated clearly.
By Bank transfer:	Payments must be made after receipt of our invoice, in Euros and free of all bank charges to: ABN-AMRO BANK N.V., The Hague, The Netherlands IBAN code: NL98ABNA0432434690, SWIFT (BIC) Code: ABNANL2A, Netherlands National Committee of the IDF Please mention the participant's name and registration number

By Credit Card: *)	Visa Eurocard/Mastercard American Express Dinners Club
	Card nr.
	Name card holder
	CVC/CID code*
	Expiration date
	* Eurocard/Mastercard/VISA: The LAST 3 NUMBERS of the number on the BACK of your CREDIT CARD. * American Express: the CID code on the front of your CREDIT CARD
*) Credit Card Payments: if you have paid by credit card "Wageningen Academic Publishers" will appear on your credit card statement.
Payments by cheque will not be accepted.

Cancellation Policy

The Conference Management must be notified in writing of cancellations on or before 1 August 2008. Payment will be refunded after the conference, minus an administration fee of € 50,00.
For cancellations made after 1 August 2008, no refunds can be made. Registrations are not transferable to other participants. No refunds will be made for non-attendance. Registration implies acceptance of all terms and conditions.

Questions / remarks