Registration Form for Participants

Download PDF version here. Fax completed form to Ryan Dean at Greater Morgantown CVB (+1 304 291 1354).


Section 1. Personal Particulars

( * required fields)

Please specify your
ISCEV Membership Status
* Family Name
Middle Initial
* First Name
* Name (exactly as you want printed on the Delegate Badge and certification)
Title
Degree
* Date of Birth (dd-mm-yyyy)
* Affiliation
(Name the Hospital / Laboratory / University / Company, if applicable)
* Designation
* Mailing Address
* City
* Pin/Zip Code
* State / Province
* Country
* Telephone (office)
(country code / city code / telephone no.)
Mobile Number
Fax
(country code / city code / telephone no.)
* E-mail address


Section 2. Registration

(Please see Registration Fee details given below)

* Delegate Category



* Registration Category

Registration Amount

Accompanying Persons Registration
Registration Category of Accompanying Persons

Accompanying Person Rate
Names of Accompanying Adults
Number of Accompanying Adults
Registration Category of Accompanying Children
Accompanying Children Rate
Names of Accompanying Children
Number of Children (7-15 years)
Number of Children ( under 7 years)
Food Preferences:
None, Kosher, Halal, Vegetarian
Food Allergies (if any) - specify
All Students (including undergraduates / graduates / fellows / residents etc) must provide name and email/address of their supervisor


Credit Card Information

Cardholder's Name
Address
City
State/Prov.
Zip/PIN
Country
Home Phone
Card #
Expiration Date
Security Code#
In order for this transaction to be accepted and processed, you must enter this code if it's printed on your card. This is done for your protection.
Type of Card
Visa Mastercard American Express Discover



Registration Fee Information

1. ISCEV 2008 SYMPOSIUM FEE ONLY


Before
May 10, 2008 		After
May 10, 2008

ISCEV Members

US$ 580

US$ 640

ISCEV Junior and
Emeritus Members

US$ 480

US$ 540

Travel Grant Recipients

-----­

US$ 200

Non-members

US$ 640

US$ 690

Non-member
Students/Fellows/Trainees

US$ 480

US$ 540

Accompanying Persons (Adult)

US$ 480

US$ 540

Children
(7 -15 years, evening meals and tours)

US$ 300

US$ 350

Children
(under 7, pay locally for food etc)

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2a. ISCEV BASIC ELECTROPHYSIOLOGY (HUMAN) COURSE FEE ONLY


Before
May 10, 2008

After
May 10, 2008

All delegates

US$ 350

US$ 380

Additional Adult Ticket For
Course Social Function

US$ 70

US$ 70

2b. ISCEV BASIC ELECTROPHYSIOLOGY (ANIMAL) COURSE FEE ONLY


Before
May 10, 2008

After
May 10, 2008

All delegates

US$ 350

US$ 380

Additional Adult Ticket For
Course Social Function

US$ 70

US$ 70

3. ISCEV 2008 + ISCEV COURSE FEE


Before
May 10, 2008 		After
May 10, 2008

ISCEV Members

US$ 700

US$ 750

ISCEV Junior and
Emeritus Members

US$ 600

US$ 675

Travel Grant Recipients

-----­

US$ 350

Non-members

US$ 750

US$ 800

Non-member
Students/Fellows/Trainees

US$ 600

US$ 675

Accompanying Persons (Adult)

US$ 480

US$ 540

Children
(7 -15 years, evening meals and tours)

US$ 300

US$ 350

Children
(under 7, pay locally for food etc)

-----­

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4. I need a registration verification letter for visa purposes (Do I need this?)

Payment Information:

All payments must be made in U.S dollars. Payments can be made by credit card only using our online checkout or by phone. Full refunds are available for cancellations up to June 6 and a 50% refund is available up to June 26. For all payment questions and phone payments please contact Ryan Dean at the Greater Morgantown CVB at 800-458-7373.