THE FOURTH EUROPEAN WORKSHOP
ON CELL DEATH

Registration
Registration
Form Template
Surname: Address:
First
name:
Phone:
E-mail
:
Sex:
Do
you require transport from Istanbul Airport to the hotel (this is
free, but only on the 11th and 16th May)?
Yes / No (type
one of these)
If
‘yes’, complete details below, if ‘no’ skip to next section.
Local
time of flight arrival at Istanbul Airport on 11th May:
Flight
departure time from Istanbul Airport on 16th May:
Do
you require a single room? (n.b. there is a 150 Euro
supplement to the total cost) Yes
/ No (type
one of these)
If
‘no’, please provide details of a preferred roommate, if
possible:
Are you a smoker? Yes / No (type one of these)
Special
dietary requirements:
Do you require extra nights at the hotel? Yes / No (type one of these)
If
‘yes’, I will arrive at the hotel on (put
date here) and
depart on (put
date here)
.
I
require a single / twin / double room / family suite for the
extra nights (type
one of these)
Credit
card details:
Type
of card: Name on
card:
Card
number: Expiry
Date:
Or
I would like to be considered for a EWCD Scholarship
(Card details not required)
For
alternative methods of payment, please contact Huseyin Mehmet
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