Please return to: ISPE Registration Services
Avenue de Tervueren, 300 • B-1150 Brussels, Belgium
Tel: + 32 2 743 44 22 Fax: + 32 2 743 1584
E-mail: europeregistrations@ispe.org
Registration Form
SAVE TIME – REGISTER ONLINE: www.ISPE.org/2012AsepticEUConference
I. Delegate Information
Prefix:___________ First Name:_ _____________________________________________ Last Name:______________________________________________________________________
Job Title:__________________________________________________________________ Company:_______________________________________________________________________
Address:__________________________________________________________________________________________________________________________________________________
City:______________________________________________________________________ Postal Code:________________ Country:_____________________________________________
Telephone:________________________________________________________________ Fax:____________________________________________________________________________
Mobile:___________________________________________________________________ Email:___________________________________________________________________________
Company VAT number (mandatory):__________________________________________________________________________________________________________________________
q I wish to keep my data confidential (only for use by ISPE and its local Affiliates and Chapters) q I do not wish for my details to be printed in ISPE’s Membership Directory or on Conference Attendance Listings
II. Conference Registration
Prices below do not include VAT – 19% German VAT is applicable on registration fees only.
Are you an ISPE Member? q Yes , membership number: _______________________ q No
If you wish to become a Member of ISPE and benefit from lower registration fees, please select New Member registration fees.
€210 (VAT exempt) for your one-year membership is included in the New Member fees indicated below. If you do not wish to
become a Member of ISPE, please select the Nonmember fees.
Please note that academia, emerging
economy, government and student Members
benefit from discounts on the registration fees.
For further details please contact ISPE
Registration Services at
tel: + 32 2 743 44 22 or e-mail
europeregistrations@ispe.org
q Tick here if you are a first time attendee
The Global Evolution of Aseptic Processing:
Implementing Risk-Based Manufacturing Solutions
Monday 26 – Tuesday 27 March, 2012
q Track 1: Barrier Isolation
(Price includes the ISPE Baseline® Guide: Sterile Product Manufacturing
Facilities – 2nd Edition)
q Track 2: Technology Innovations in Aseptic Processing
(Price includes the ISPE Baseline® Guide: Sterile Product Manufacturing
Facilities – 2nd Edition
q Track 3: Aseptic Technologies for Vaccine Manufacturing
(Price includes the ISPE Baseline® Guide: Sterile Product Manufacturing
Facilities – 2nd Edition)
Professional Development Training Frankfurt 2012
Wednesday 28 – Thursday 29 March, 2012
q Facility Project Management in the Regulated Pharmaceutical Industry – New Course
EARLY BIRD ON OR BEFORE
2 MARCH 2012
REGULAR / ONSITE AFTER
2 MARCH 2012
Member
New
Member
Nonmember
Member
New
Member
Nonmember
€1.470
€1.680
€1.765
€1.670
€1.880
€1.975
€1.470
€1.680
€1.765
€1.670
€1.880
€1.975
€1.470
€1.680
€1.765
€1.670
€1.880
€1.975
EARLY BIRD ON OR BEFORE
2 MARCH 2012
REGULAR / ONSITE AFTER
2 MARCH 2012
Member
New
Member
Nonmember
Member
New
Member
Nonmember
€1.510
€1.720
€1.805
€1.710
€1.920
€2.015
III. Method of Payment
(19% German VAT should be included in the total payment, excluding €210 membership fee on New Member registrations)
Seminar Fees 19% VAT €__________________
€ _________________
Total Due:
€__________________
q Credit Card q Amex q Visa q Mastercard­
Credit Card Number: |—|—|—|—| |—|—|—|—| |—|—|—|—| |—|—|—|—| Expiry Date: |—|—| / |—|—| Cardholder’s Name:_ ___________________________________________________________________________________ Signature:
IV. Special Needs (dietary or other):_______________________________________________________________
­­
V. Hotel InformationRadisson Blu Hotel
Room rates: Franklinstrasse 65, D-60486 Frankfurt, Germany_
Tel: +49 (0)69 770 155 0 / Fax: +49 (0)69 770 155 10_
reservations.frankfurt@radissonblu.com - www.radissonblu.com/hotel-frankfurt
Single room: 149 € - Double room: 159,50 €
(Rates include current VAT and service charges)
ISPE has secured a number of bedrooms at a fixed group rate for your
convenience. All accommodation bookings must be made directly with
the hotel and are subject to availability.To benefit from the ISPE group
rate, reservations must be made before 19 February 2012.
To book rooms online, please visit
www.radissonblu.com/hotel-frankfurt and go to the booking section
on the right side..
Click “More search option” and then enter “ISPE” into the field
“Promotional Code”. From here on process with the normal booking.
VI. Signature By signing I agree with the ISPE Registration and Cancellation Policies (see www.ISPE.org/2012AsepticEUConference)
Date:____________________________________ Signature: