ADSW&EC 2011 Registration Form

ADSWEC 2011 Registration Form page 1 of 2 REGISTRATION FORMREGISTRATION FORMREGISTRATION FORMREGISTRATION FORM (Online registration is highly recommended at www.(Online registration is highly recommended at www.(Online registration is highly recommended at www.(Online registration is highly recommended at www.adswec2011.org)adswec2011.org)adswec2011.org)adswec2011.org) MONDIAL CONGRESS & EVENTSMONDIAL CONGRESS & EVENTSMONDIAL CONGRESS & EVENTSMONDIAL CONGRESS & EVENTS Operngasse 20b A-1040 Vienna Austria Tel.: +43 1 58804 – 0 Fax: +43 1 588 04 185 Email: adswec2011@mondial-congress.com Web: www.adswec2011.org PARTICIPANT INFORMATIONPARTICIPANT INFORMATIONPARTICIPANT INFORMATIONPARTICIPANT INFORMATION ? Mr. ? Mrs. ? Ms. Title: Last Name: First Name: Organisation: Address: City: Postcode: Country: Tel: Fax: Email*: * = Compulsory Field as all confirmations will be sent via email REGISTRATION REGISTRATION REGISTRATION REGISTRATION Early BirdEarly BirdEarly BirdEarly Bird FeeFeeFeeFee until Friday, July 1, 2011 Late FeeLate FeeLate FeeLate Fee from Saturday, July 2, 2011 MeetingMeetingMeetingMeeting Non-Members ? € 600,00 ? € 700,00 IWA-Members ? € 500,00 ? € 600,00 Students (until the age of 27)* ? € 300,00 ? € 400,00 Low & Medium Income Countries (OECD)** IWA-Members ? € 300,00 ? € 400,00 Low & Medium Income Countries (OECD)** Non-Members ? € 400,00 ? € 500,00 Accompanying Persons ? € 200,00 ? € 200,00 Social EventsSocial EventsSocial EventsSocial Events Welcome Reception on Sunday, August 28, 2011 ? included Conference Dinner on Monday, August 29, 2011 ? included * Students need to provide a copy of their valid Student ID, otherwise the student registration will not be accepted. Student fee is valid until the age of 27 only (born in 1984 or younger) ** further details can be found on the conference website: www.adswec2011.org CANCELLATION POLICYCANCELLATION POLICYCANCELLATION POLICYCANCELLATION POLICY Refunds – less EUR 40,00 administrative fee – will be granted to delegates unable to attend, provided written notice is received by Mondial Congress & Events by Tuesday, June 1, 2011. No refunds will be granted for cancellations received after this date. ADSWEC 2011 Registration Form page 2 of 2 TECHNICAL TOURSTECHNICAL TOURSTECHNICAL TOURSTECHNICAL TOURS Tour 1: Energy crop AD plants (incl. biogas upgrade) Sept. 1, 2011, 09:00-16:00. ? € 20,00 Tour 2: Organic waste AD plants (incl. biogas upgrade) Sept. 1, 2011, 09:00-16:00. ? € 20,00 HOTEL BOOKINGHOTEL BOOKINGHOTEL BOOKINGHOTEL BOOKING (Booking deadline: (Booking deadline: (Booking deadline: (Booking deadline: TuesdayTuesdayTuesdayTuesday, June 1, 2011, June 1, 2011, June 1, 2011, June 1, 2011)))) HotelHotelHotelHotel Single RoomSingle RoomSingle RoomSingle Room (Deposit of 2 nights requested) Double RoomDouble RoomDouble RoomDouble Room (Deposit of 2 nights requested) 4 Star ? € 155,00 - 230,00 ? € 170,00 - 247,00 3 Star ? € 97,00 - 169,00 ? € 124,00 - 184,00 2 Star ? € 56,00 - 80,00 ? € 74,00 - 92,00 1st Choice: 2nd Choice: Arrival Date: …………………....... (DD/MM/YY) Departure Date: ………….....……….. (DD/MM/YY) = number of nights …………. • Late Arrival (ca. ………….. h) Remarks: …………………………………………………………………………………………………..……………………. Hotel List & Location Hotel List & Location Hotel List & Location Hotel List & Location Map Map Map Map online at www.online at www.online at www.online at www.adswec2011.orgadswec2011.orgadswec2011.orgadswec2011.org TERMS & CONDITIONSTERMS & CONDITIONSTERMS & CONDITIONSTERMS & CONDITIONS As soon as the Organising Secretariat has received your payment, a letter of confirmation will be e-mailed or faxed to you. It will confirm the name of your hotel, the room rate per night and the duration of your stay, as well as the total cost of your stay. If the hotel category requested is no longer available, Mondial Congress & Events will do its utmost to offer similar accommodation. This may, however, involve a change in price category. The number of nights booked is binding and will serve as the basis for your hotel invoice. In case of early departure, Mondial Congress & Events is entitled to charge all nights booked. For cancellations received by Tuesday, June 1, 2011, an administrative fee of EUR 40,00 will be charged. For cancellations received after Tuesday, June 1, 2011 deposit payments shall be forfeited. Only written cancellations will be accepted. Amounts due will be reimbursed after the Congress. CREDIT CARD DETAILSCREDIT CARD DETAILSCREDIT CARD DETAILSCREDIT CARD DETAILS I herewith authorize Mondial Congress & Events to charge my credit card: ? VISA ? MASTERCARD ? AMEX ? DINERS Cardnumber: Expiry Date: Name of Cardholder: Signature: Amount in EUR: ____________ BANK TRANSFERBANK TRANSFERBANK TRANSFERBANK TRANSFER Account name: ADSWEC 2011 Account number: 52946 026 867 Bank sorting code: 12000 IBAN: AT93 1200 0529 4602 6867 BIC: BKAUATWW Please transfer the amount “Free of charge for Mondial Congress & Events” Bank fees will be charged to the participant. Mondial Congress shall act as a mediator only and cannot be held responsible for any loss or damage incurred. The liability of transport and other service companies shall not be affected by the above. Only written agreements shall be valid. The place of jurisdiction shall be Vienna Date: Signature: