Registration International Workshop on Contact Dermatitis

The event is open to the public; however the number of participants is limited. The workshop language will be English.
A conference fee of 100 EUR per participant applies, covering the coffee breaks, lunches and the “Get-together”.

I hereby register for the Workshop at the BfR, October 27-28, 2008.

Title
Last Name
First Name
Institution
Street
ZIP Code, City
Country
eMail-Address
Telephone

I will join the “Get-together” on Monday, October 27, 2008.

	Yes
	No

Please transfer the conference fee including any bank transfer costs before October 20, 2008 to the account:

Deutsche Bundesbank Filiale Kiel

Account:	210 010 30
Bank sorting code:	210 000 00
IBAN:	DE42210000000021001030
BIC:	MARKDEF1210
Purpose/Keyword:	BfR Contact Dermatitis; Name of participant

I understand that the limited number of course places will be allocated in the order of receipt of registration and payment.