36th Annual Meeting of the International Society for Dermatologic Surgery, Seoul, 2015 October 1~4, COEX ISDS 2015 CONGRESS REGISTRATION FORM Please kindly complete this form and send to ISDS Seoul Office isds2015@koconex.com [1] Personal Information (Please type or print clearly) Title Dr. Prof. Mr. Mrs. First (Given) Name Last (Family) Name Country Department Ms. Other Organization Address Phone Fax E-mail Special Requirements: Special dietary. Accompanying Person 1 First (Given) Name Last (Family) Name Special Requirements: Special dietary. [2] Check your choice A. Registration Early-bird until July 31, 2015 After July 31, 2015 ISDS Member € 300 € 500 Non Member € 400 € 700 Resident € 150 € 200 $ 300 Asian Group Registration (Min. 10 pax) ISDS Member Developing Country € 200 € 400 Physician from Developing country € 250 € 400 Spouse Pass* € 200 Exhibitor Badge** € 50 € Sub Total (A) If you are registering as a resident, Certificate of Employment must be sent to the local congress secretariat along with a copy of your passport by fax (+82.2.3476.8800) or e-mail (isds2015@koconex.com). *Spouse Pass: Access to Exhibition Area, Welcome Reception, Coffee Breaks, Traditional Day & Night **Exhibitor Badge: Access to Exhibition Area, Opening Ceremony, Plenary Lectures, Welcome Reception, Coffee Breaks B. Course Date & Time Program October 1, 09:00-10:00 (Breakfast will be provided) Physician Resident 1. ANATOMY for Facial Injectables € 50 € 30 2. ANATOMY for Dermatologic Surgery for Flaps and Grafts € 50 € 30 3. Liposuction and Fat Grafts € 50 € 30 Tel: +822-3476-7700 [ISDS 2015 Seoul Secretariat] Fax +822-3476-8800 E‐mail: isds2015@koconex.com 36th Annual Meeting of the International Society for Dermatologic Surgery, Seoul, 2015 October 1~4, COEX October 2, 07:30-08:30 (Breakfast will be provided) October 3, 07:30-08:30 (Breakfast will be provided) 4. Hyperhidrosis € 50 € 30 5. All about Scar Treatments € 50 € 30 6. Thread Lifting € 50 € 30 7. All about Periorbital Rejuvenation € 50 € 30 8. How to Create a Beautiful Smile € 50 € 30 9. How to Diagnose Skin Cancer with Dermoscopy € 50 € 30 € € Program Physician Resident Flaps and Grafts the Old teach the Young including Anatomy Basics (Resident only) - Sub Total (B) C. Post Congress Workshop (October 4, Sunday) Time 09:00-17:00 09:00-13:00 13:00-17:00 Place COEX Korea University College of Medicine € 30 Fresh Cadaver Workshop Focused on Regional Face Anatomy for all Injectables € 300 € 300 Fresh Cadaver Workshop Focused on Flaps and Grafts Surgery and Nail Anatomy € 100 € 100 09:00-13:00 Modelo Clinic Botox and Filler for Advanced including Live Patient treatment € 300 € 300 09:00-13:00 Dr. Hwang’s Hair Transplantation Center Hair Transplantation with Live Patient Treatment € 300 € 300 09:00-13:00 Cell Park Clinic Liposuction Fat Graft and Body Volumazation including Live Patient Treatment € 300 € 300 09:00-13:00 Bundang Seoul National University Hospital Laser and other Energy Driven Technology in 2015 for Dermatologic Surgeons including Live Patient treatment € 300 € 300 € Sub Total (C) € D. Social Events Date & Time Place Program Admission Fee October 1, 19:00-20:00 COEX Grand Ballroom Lobby Welcome Reception included October 2, 14:30-18:00 Changdeokgung, Jongmyo Shrine Traditional Day in Seoul (City Tour) included October 2, 18:30-21:00 Korea House Traditional Night included October 3, 19:30-24:00 Sebitseom (Sebit island) Gala Dinner € 85 € Sub Total (D) [3] Payment Information (Please select your payment method.) Total Payment: (A)+(B)+(C)+(D) Tel: +822-3476-7700 € [ISDS 2015 Seoul Secretariat] Fax +822-3476-8800 E‐mail: isds2015@koconex.com 36th Annual Meeting of the International Society for Dermatologic Surgery, Seoul, 2015 October 1~4, COEX Bank Transfer Bank Information Bank Name: SHIN HAN BANK Account Holder: ISDS2015 Account Number: 140-009-875860 Bank Address: 20, sejong-daero 9-gil, jung-gu, Seoul, South Korea Swift Code: SHBKKRSE Sender’s Name: A duplicate or photocopy of the bank transfer statement with the applicant’s name and address in addition to the payment details must be sent to the ISDS2015 local Secretariat by fax or e-mail. All bank service charges are to be paid by the applicants. Checks will not be accepted. Names of applicant and sender should be same. If not, please inform to ISDS2015 local Secretariat. A confirmation letter will be forwarded to you after we have received your full payment. All registration process will be completed after the registration fee has been paid. Credit Cards Card Information Cardholder’s Name: Card Number: Expiration Date: CVC2/CVV2: Authorized Signature: Registration fees may be paid by credit only through the secure online system. Only VISA, Master and JCB cards are accepted. [4] Cancellation Policy All cancellations must be submitted in writing via fax or e-mail to the local Congress Secretariat. All refunds will be processed after the completion of the ISDS2015 according to the following policy and all processing fees will be deducted from the reimbursement. Up to July 31, 2015: 100% of the registration fee will be refunded. From August 1 to 31, 2015: 50% of the registration fee will be refunded. From September 1, 2015: No refunds will be given for cancellations received on or after this date. If you do not attend the congress without notice of cancellation, no refund will be given. All dates are based on Korean standard time (GMT+9). [5] Visa & Passport All foreign visitors entering South Korea must possess valid passports. Nationals of most countries may enter visa-free for a maximum duration of 30 days, given possession of confirmed return or alternate destination tickets. For a list of countries with visa-free entries and countries under visa exemption agreements, please go to www.mofat.go.kr/ENG/visa/application/index.jsp. For more specific information regarding visa requirements, please contact your local Korean consulate. Tel: +822-3476-7700 [ISDS 2015 Seoul Secretariat] Fax +822-3476-8800 E‐mail: isds2015@koconex.com