Online-Registration (Debit Advice)

Academic title
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Hospital, institute, practice etc.





The following address is
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Area code, phone number *
Fax
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Conference Full Reduced 1
Total Conference
Day ticket
Wednesday, April 3, 2019
Day ticket
Thursday, April 4, 2019
Day ticket
Friday, April 5, 2019
Day ticket
Saturday, April 6, 2019
1 for members of AGO, ESGO or NOGGO or PARSGO as well as assistant physicians

Workshops (only in combination with a conference ticket)
Intensive Workshop Ovarian Cancer
Wednesday, April 3, 2019
50,- € extra charge
Intensive Workshop Breast Surgery
Thursday, April 4, 2019
50,- € extra charge
Intensive Workshop Cervical Cancer
Saturday, April 6, 2019
50,- € extra charge

Social programm Persons Price per person
Welcome Evening
Thursday, April 4, 2019
20,- €
Festive Evening
Friday, April 5, 2019
50,- €

Terms and conditions of registration

The closing date for pre-registration is March 29, 2019. Following receipt of your fully completed registration form, we will confirm your registration by email or fax. In case of cancellation (in writing only) up to four weeks prior to the start of the event, an administration fee of EUR 50 per person will be charged. In case of cancellation up to two weeks prior to the event, half of the participation fee shall be payable. Payment of the full participation fee shall be due in the event of cancellation at a later date or failure to appear at the event. Naturally, you have the right to nominate a replacement participant. The event organizer reserves the right to make alterations to the program without prior notification.

SEPA direct debit authorization

I hereby give Jörg Eickeler, Beratung · Organisation · Veranstaltung a revocable title to collect the fees for the Charité-Mayo-Conference when due from my account by SEPA debit advice procedure. If there should not be enough funds on my account, the account-holding bank does not have the obligation to honour the payment. In the case of non-payment or incorrect details on the bank account, I untertake to charge Jörg Eickeler, Beratung · Organisation · Veranstaltung for the costs thereby incurred. Portioned encashments in debit advice procedures shall not be made."

Credit card authorization

I hereby give Jörg Eickeler, Beratung · Organisation · Veranstaltung a revocable title to collect the fees for the Charite Mayo Conference when due from my credit card. In the case of non-payment or incorrect details on the credit card. I untertake to pay Jörg Eickeler, Beratung · Organisation · Veranstaltung for the costs thereby incurred."

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