If you have any question, please contact:
Dr David Vaudry
Mail: david . vaudry @ univ - rouen . fr
Phone: +33 235 14 6760
Location: Mont-Saint-Aignan, France

Participant
Title: *
Family name: *
First name(s): *
Position: * MSc PhD Post-Doc
Other, please specify:
Institution: *
Postal address: *
Zip Code: *
City: *
Country: *
Tel:
Fax:
e-mail: *
Confirm e-mail: *



Registration fees
Registration
Before or on 2016/07/08		 Registration
After 2016/07/08
Regular  450 €  550 €
Student / Post-doc
Copy of student identification or letter from the research advisor must be provided:
 250 €  300 €
Accompanying Person  200 €  210 €
Lunch * no yes 07/12
07/13
07/14
 Included Included
Gala Dinner - 07/13 * no yes Included Included
Visits of Rouen Museums - 07/13 * no yes Included Included
Visit of Rouen Downtown - 07/14 * no yes Included Included


Registration Fees Include:
  • All Sessions
  • All official documentation and materials, including program booklet, copy of abstracts and list of participants
  • Postdoctoral participants are regarded as regular participants.


Symposia

Thank you to specify which symposium you would like to attend in 1st choice (see information):


Thank you to specify which symposium you would like to attend in 2nd choice:


Thank you to specify which symposium you would like to attend in 3rd choice:


Thank you to specify which symposium you would like to attend in 4th choice:


Thank you to specify which symposium you would like to attend in 5th choice:



Payment * All payments must be in Euro and payable to INSERM
Registration will be confirmed when INSERM has received your payment. Payment must be remitted as follows:

    by credit card:
You will be redirected on the payment page after you confirm your registration below. The payment form is only available in French for the moment but all the information will be prefilled, you have just to tick the agreement "J'accepte les conditions d'utilisation" and click on "Valider" to be directed on the credit card information page. Please note that the two fields "Numéro SIRET organisme" & "Numéro de TVA intracom" are to be filled only by participants from french companies, please write "XXXXX" if you are not in this case.

For example :

Intitulé colloque/formation (Congress name) : RegPep 2016 Registration
Date (dd/mm/yyyy) : 16/03/2016
Numéro SIRET organisme (Only for french society) : XXXXX
Numéro de TVA intracom (Only for french society) : XXXXX
Nom de l'organisme (Institution) : INSERM
Nom (Last Name) : Vaudry
Prénom (First Name) : David
E-mail : david . vaudry @ univ - rouen .fr
E-mail (Confirmation) : david . vaudry @ univ - rouen . fr
Adresse (Postal Address) : University of Rouen
Code postale (Zip code) : 76821
Ville (City) : Mont-Saint-Aignan
Montant à régler (Registration Fee) : 400
J'accepte les conditions d'utilisation : Tick to accept the conditions of Use

Click on " Valider " (Confirm) button

For the next step, you can click on the US flag to switch the form in English.

    by bank transfert:
Please find below the bank account details of the congress:

SWIFT Code: TRPUFRP1
Account Name: ACS INSERM DE LILLE
Bank Name: TRESOR PUBLIC
Branch Name: TP LILLE
Account No: 00001004002
IBAN No : FR76 1007 1590 0000 0010 0400 227

VAT number of Inserm is FR31180036048




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Design by Alexis Lebon © RegPep2016, 2015-2016 - All rights reserved - Imprint.

Contact:

Dr David Vaudry
Mail: david . vaudry @ univ - rouen . fr
Phone: +33 235 14 6760
Location: Mont-Saint-Aignan, France