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Participant

Title *

Dr.

First name *

Last name *

Organisation/Company *

Function *

Address *

City *

ZIP code *

Country *

Email address *

Telephone number *

Arrival date *

Month

Day

Year

Departure date *

Month

Day

Year

Spouse

Title

Dr.

First name

Last name

Special requirements

Please indicate below any special requirements you have (i.e. disabled access, late arrival, dietary requirements, etc.)

Translation

Will you require translation facilities?

Yes

If so, please indicate the language for which you will need translation*

* Please note that translation facilities will only be provided for a MINIMUM of 10 delegates requiring a particular language, but cannot be supplied on an individual basis.

Accommodation

This year we will be moving to Bucharest to hold the conference in the stunning InterContinental Athénée Palace Bucharest.

Please note that GIRP has negotiated discounted rates for conference participants at the venue, should you wish to take advantage of these rates, we kindly ask you to please reserve your room via this link: https://www.ihg.com/intercontinental/hotels/us/en/bucharest/buhap/hoteld...

Registration Fee

The conference registration fee includes participation in the social programmes but excludes travel and accommodation.

Fees *

Member only rate - 1800 €

Member and accompanying person rate - 2220 €

Non-member only rate - 2100 €

Non-member and accompanying person rate - 2420 €

VAT Number*

* Should you need your organisation's VAT Number featured on the participation invoice, please indicate the number here above.

Registration fees have to be settled prior to the conference by:

International bank transfer

Please make your bank transfer payable to GIRP, bank account number N° 210-0831484-52 at the BNP Paribas Fortis Bank, Place Andrée Payfa-Fosseprez 7, 1170 Watermael-Boitsfort, Belgium.
BIC: GEBABE BB
IBAN: BE64 2100 8314 8452
Reference: Participant’s Name and Surname, GIRP AMC 2023

PayPal

In this case please provide the email address where we can send the payment request.

PLEASE FILL IN THIS FORM PRIOR TO 19^ND MAY 2023.

I accept the GIRP event terms and conditions *

Yes

Register now

International bank transfer

PayPal

PLEASE FILL IN THIS FORM PRIOR TO 19ND MAY 2023.

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PLEASE FILL IN THIS FORM PRIOR TO 19^ND MAY 2023.