Medical Research Institute, Alexandria University
18th Annual Conference - 6th International Conference
23rd -26th September 2013
Multidisciplinary Approach in Cancer Management

Please fill in all fields marked with a *

PARTICIPANT’S DETAILS

Title Prof   Dr    Mrs  Ms   Mr   *
First Name *
Middle Initials *
Family Name *
Nationality *
Passport Number *
Professional Activity Clinician    Researcher   Scientific officer technologist    Physiotherapist   Nurse   *
Company Organization *
Mailing Address *
Postal Code
City *
Telephone
Facsimile
E mail *

Registration Fees

All  fees are quoted in Egyptian pound .

Registration includes participation in the scientific program , conference kit , and coffee breaks ( Scientific ) , in addition to three lunches ( Full ) .

 

1 April - 31 July 2013 August 1 August - 23 Sept. 2013
Scientific L.E.  300 L.E. 375
Full L.E. 700 L.E. 800

 

 Please specify your choice for the registration
Registration Scientific  Full

Accompanying persons are exempted from the registration fees and in case of full registration for the active participant,  an amount of 200 L.E. is requested for the accompanying person covering 3 lunches .
I request 3 lunches for my accompanying person

 Accommodation

An attractive rate has been obtained from 5 star hotel

Deadline for hotel reservations 31th of August , 2013

An exhibition of the latest technical equipment, diagnostic and pharmaceutical products will be held at the exhibition area.                                                                
(Reservation is required) .     

 
Accommodation Booking I require accommodation  I do not require accommodation
Date of arrival
Date of Departure
Room Type Single Room    Double room
No of nights
No of rooms
No of Accompanying person s
Person 1 First Name
Person 1 Last Name
Person 1 Passport No
Person 2 First Name
Person 2 Last Name
Person 2 Passport No

SOCIAL  ACTIVITIES

A- Gala Dinner 
B- Site Seeing Tour                (Reservation is required)

Gala Dinner No of tickets required

Cancellation and REFUND Terms

Registration fees

The secretariat must be notified of all cancellations in writing. Refund will be made within 4 weeks following conclusion of the meeting
Cancellation until 15th of August, 2013  :  Full refund
Cancellation until 15th of september, 2013: Refund amount 50%
Cancellation after 15th of september, 2013 : No refund

Accommodation

Hotel deposits will be refunded, less 10 % administrative fee, provided a written cancellation is received by  September 30th , 2013. After this date , hotel deposits will not be refunded .

Social

No refunds will be made after September 30th , 2013 .
I agree with the cancellation and refund terms *

METHODS OF PAYMENT

By bank transfer to the NSGB Bank.

Kafr Abdou Branch   (26 Ismailia Street, Corner of Ismailia Street with St., Giny Street Kafr Abdou, 21311 Alexandria )  Swift Code: NSGBEGCXXXX      
Account Name. :PL Events      Account No. :1000948563

After Payment , Pleas Send Us The Receipt Of Bank Deposition ( BY Email Or Fax )

Or directly to the conference secretariat : Vice-Dean’s office         

       ( 165,El-Horreya Avenue ?El-Hadara 21561, Alexandria )