/ XII International Pharma Licensing Symposium
Hilton Berlin, Germany
Wednesday 16th - Friday 18th September 2015

To register for the XII IPLS Meeting, please complete this form and return to NGA using one of the following methods:

PostNGA, The Red House, Kingswood Park, Bonsor Drive, Kingswood, Surrey, KT20 6AY, UK

EmailFax00 44 (0)1737 379 802

Title / Dr / Mr / Mrs / Ms / Name
Job Title
Company
Address
Country
Telephone
Email(general contact)
Email (delegate contact system)
Special Requirements (e.g. dietary, wheel chair access)
VAT Number (must be completed to confirm registration)
Price / €875 Early Payment Discount Rate / Extended for payments received by 31st May2015
€1,025 Standard Rate / for payments received after 1stJune 2015
Accommodation / Discounted rates can be booked directly with the Hilton Berlin in conjunction with this meeting, with an early bird rate available until 15th May. These rates can be booked using the link via our website,
Payment / Payment by Cheque / made payable to ‘NGA’ at the address above
Payment by Bank Transfer / details will be sent out with booking confirmation
Payment by Credit Card / MasterCard or Visa only, complete section below
Name of Card Holder
Credit Card Number
Expiry Date / Security Code
Cardholder Signature / Date

The online delegate contact system will be opened at the beginning of June, at which time you will be emailed a password to allow you access to the delegate contact system on the PLG Europe website,

Booking Terms & Conditions
Fee
The attendance fee includes attendance at all sessions noted on the programme, all breaks, lunches and networking events.
Please note that for reasons beyond the control of the organising committee it may prove necessary to change or amend the content or timing of the programme without prior warning.
Meeting Registration – No Shows
If having received a confirmed booking to the meeting, individuals who do not attend the meeting without prior notification to NGA in writing, will be liable for the full registration fee. / Meeting Cancellations
Upon receiving your completed registration form, NGA will issue confirmation details and this booking will then be formally confirmed.
Please note that all cancellations will be subject to a €50 administration charge. Delegate substitutions are welcome at any time.
Cancellations received in writing after 1st August 2015 will be subject to 100% cancellation charge unless the place can be re-sold to another delegate. In this case the €50 administration charge will apply.
All cancellations must be sent to NGA in writing.