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					           13th
                   International Neuroscience Winter Conference March 29th - April 2nd 2011
                                              Sölden, Austria

                                                           Deadline for abstracts: Feb. 18th, 2011

Mail completed form to Alois Saria, Experimental Psychiatry Unit, Innrain 66a A-6020 Innsbruck, AUSTRIA, or fax to +43-512-504 23716
or Email to conference secretariat (registration@winterneuroscience.org)


REGISTRATION FORM
Name..........................................................................................................................................................................................................

Affiliation.....................................................................................................................................................................................................

Address......................................................................................................................................................................................................

Phone................................................................................................................

Fax....................................................................................................................

Email.................................................................................................................


Signature (I accept payment, cancellation and limited liability regulations):                                                        x..........................………………..…….................

Registration fee :
(€ 360,- regular, € 180,- students & post-docs max. 2 years)                                                                         Total due (€)                     ...............................……….

Form of payment (please tick where appropriate):

o Bank transfer to Hypo-Bank AG, Innrain 47a, A-6020 Innsbruck, routing number 57000, acc.no.30053185336 (attn. INWC)
BIC: HYPTAT22, IBAN: AT665700030053185336 (please enclose copy of bank transfer)

Credit Card:             o Visa         o MasterCard

Card #.....................................................……………………….….......Expires .........…….......…..........CVC 2* ……………………………….
                                                                                                                 * last 3 digits of number printed on the
                                                                                                                  back of credit card
Cardholder’s name.........................................................................................


Signature x...........................................................................…......................
Please fill in or tick where appropriate. Payment of registration fee is required for acceptance of registration. Registrations indicating
payment by bank transfer are only processed if a transfer statement is included or otherwise when the transfer has been completed.
Student fee applies to students or post-docs no more than 2 years after completing PhD or MD. A short CV and a letter by the supervisor
is required to qualify for the student fee. Payment in € (EURO). The registration fee includes admission to the sessions, all conference
materials, coffee and snacks during breaks, beverages during sessions and a welcome cocktail. No registration fee for accompanying
persons. Accommodation and meals at the meeting hotel are NOT included in the registration fee.
Cancellation policy: Refund of full payment minus a handling fee of 40,- by March 6th, 2011; no refund thereafter. Liability disclaimer:
The organizers do not accept liability for personal medical expenses, travel expenses, or any other personal expenses as a
consequence of accidents, weather conditions, or other unexpected events, or changes of the published program. We advise
participants to care for their own travel and health insurance.



HOTEL RESERVATION
(for Central Hotel*****, the conference venue only, rates see below)
Please note that the contingency of the meeting hotel is limited, therefore a reservation at yoru earliest convenience is recommended
Number of room(s):....................................................................

Type of room:                    o single              o double               o other (specify):

Arrival date:............................                         Departure date:.............................                       Number of nights:...............................

o     if Central Hotel is no longer available, please book me in another hotel of a similar category
o     I do not need a hotel reservation through the organizers of the conference
      (please tick where appropriate)
Rates: € 160,- per person & night (double occupancy) € 170,- per person & night (single occupancy). Rates include buffet breakfast and
5-course dinner. Please note that the hotel is a top-category hotel and rates are reduced package rates for conference delegates only
and apply if you book through the conference office. Significant reductions for children apply. No hotel deposit required.
Cancellation fees: € 160,- for cancellations less than 24 hrs before arrival or for no shows! The cancellation fee will be deducted from
your credit card only if applicable.

				
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