PLEASE COMPLETE WITH CAPITAL LETTERS AND SEND TO THE FOLLOWING ADDRESS BY EMAIL:

I. PERSONAL DATA:

Prof.  Dr. Name: ______

Institution: ______

Address:WorkplaceHome

City: ______Postal code: ______

Address (street, house number): ______

Phone number: ______Email: ______

II. REGISTRATION FEES:

Before 20 March / After 20 March
Registration fee without dinner1 /  69.000 HUF /  76.000 HUF
Registration fee with dinner2 /  78.000 HUF /  85.000 HUF
Registration fee for residents without dinner1 /  20.000 HUF /  20.000 HUF
Registration fee for students without dinner1 /  free /  free
Registration fee for assistants and dentalhygienists without dinner1 /  5.000 HUF /  5.000 HUF
The registration fees include conveyed catering services.

1Registration fee without dinner includes:access to all scientific programmes on Friday and Saturday, conference bag with programme booklet, coffee breaks, access to the exhibition.

2Registration fee with dinner includes:access to all scientific programmes on Friday and Saturday, conference bag with programme booklet, coffee breaks, gala dinner on Friday, access to the exhibition.

III. SOCIAL PROGRAMS:

12 May 2017 / Buffet lunch /  3.500 HUF
13 May 2017 / Buffet lunch /  3500 HUF
12 May 2017 / Gala dinner /  15.000 HUF

Please note! We can not accept applications for the social programs on site!

Type of meals:
traditional / vegetarian / gluten free / lactose free

IV. ACCOMMODATION:

The rooms are filled according to the order of application.

Nights: / May / 11 / 12 / Prefered choice
Forrás Hotel**** (16-24 Szent-Györgyi str) – 8 mins. by car from the venue
Single room with breakfast / 25.500 HUF/room/night /  / 
Double room with breakfast / 34.500 HUF/room/night /  / 
Dóm Hotel**** (3-6 Bajza str) – 10 mins. on foot from the venue
Single room with breakfast / 24.500 HUF/room/night /  / 
Double room with breakfast / 29.000 HUF/room/night /  / 
Hotel Auris**** (14 Boldogasszony av) - 5 mins. on foot from the venue
Single room with breakfast / 20.500 HUF/room/night /  / 
Double room with breakfast / 25.000 HUF/room/night /  / 
Hotel Mozart**** (16 Oskola str) - 10 mins. on foot from the venue
Single room with breakfast / 16.500 HUF/room/night /  / 
Double room with breakfast / 19.500 HUF/room/night /  / 
Hotel Soleil**** (7 Kelemen str) - 10 mins. on foot from the venue
Single room with breakfast / 21.500 HUF/room/night /  / 
Double room with breakfast / 27.000 HUF/room/night /  / 
Hotel Novotel**** (1 Maros str) - 25 mins. on foot from the venue
Single standard room with breakfast / 18.000 HUF/room/night /  / 
Double standard room with breakfast / 20.500 HUF/room/night /  / 
Hotel Science**** (17 Petőfi av) - 5 mins. on foot from the venue
Single room with breakfast / 18.500 HUF/room/night /  / 
Double room with breakfast / 23.000 HUF/room/night /  / 
Hotel Tisza*** (3 Széchenyi sq) - 15 mins. on foot from the venue
Single classic room with breakfast / 16.500 HUF/room/night /  / 
Double classic room with breakfast / 19.000 HUF/room/night /  / 

Rates are intended per room, per night, VAT and tourism tax are included. Parking fee, telephone, minibar service, etc. are not included.

Roommate:______

V. TOTAL FEE (REGISTRATION AND ACCOMMODATION):

______

VI. PAYMENT METHOD:

 I wire the total amount payable to the following bank account:

Bank name: MKB Bank Zrt.

Bank address: 38 Váci str, H-1056 Budapest
IBAN HUF: HU54 1030 0002 1061 9647 4902 0016

IBAN EUR: HU80 1030 0002 1061 9647 4882 0019

SWIFT: MKKBHUHB

Please include registration number you recieve with registration confirmation letter in the comment field of the transaction.

 I need an invoice made out to the details given in the personal data section

 I need an invoice to the following name and address:

Name:______

Address:______

VAT number: ______

Contact person: ______

Email address of contact person:______

VII. PAYMENT INFORMATION & CANCELLATIONS:

Confirmation and invoices:

Please send your registration to the main organizer’s office (). Within latest one week you will receive a confirmation via e-mail. If your registration fee and/or other expenses of your participation will be covered by a firm or sponsor, please kindly state the exact name, address and representative of the company. After receiving your payment we will send a proforma invoice for your attention. Please note, we can only state the name of the bank account holder on the proforma invoices. If the name of the bank account holder is different from the name of the sponsor or representative who covers the expenses, we will send the invoice with the name of the bank account holder to follow the Hungarian Accounting Rules. We ask for your kind understanding on this matter. We will send the final invoice after the event by regular post. Please note, that as per the new legislation of taxes in Hungary, you need to pay the tax of the food and bevarages services separately which we will include in your participation fee and state on your invoice.

Payment methods:

The registration fee (included with your accommodation costs) has to be paid latest until the date stated in your proforma invoice to the following bank account: Bank name: MKB Bank Zrt. Account holder: Régió-10 Kft. Bank account number: IBAN HUF: HU07 1070 2040 4374 2505 5110 0005

Cancellation policy:

Please kindly note that we can accept amendments and cancellations only in written form by e-mail or official letter. Cancellation and amendments of registration before 10 April 2017 – no amount will be charged. Cancellation and amendments of registration after 10 April 2017 – 5000 HUF+tax administrative cost will be charged per each. In case of no show – 5000 HUF+tax administrative cost and all food and beverages will be charged. Cancellation of accommodation before 10 April 2017 – no amount will be charged. Cancellation of accommodation after 10 April 2017 – total amount will be charged. In case of double or other over payments we transfer the amount after the conference. Please note that we are not responsible for the caused bank transfer costs therefore we deduct it before fulfilling the transfer.

Date:…………………………………………..Signature:…………………………………………….