How to register

How to register
Always register online if possible via 2013.excellence-in-paediatrics.org. If this is not an option, you may register for the conference by
sending the Registration Form with a scanned copy of your receipt/remittance slip showing all relevant payment information to the
Conference Organisers. From 24th November 2013 onwards, registrations will be accepted only at the Conference Secretariat operating
in the Conference Venue from 4th December till 7th December.
Send your completed Registration Form to:
The EiP 2013 Registration department
Fax: +44 (0) 208 326 5726
Email: eip@2eic.com
Registration types and fees in 2013
Full Delegate
Standard
24 Jun - 15 Sep
Late
16 Sept– 24 Nov
On-site
4 Dec - 7 Dec
690 Euros
750 Euros
830 Euros
Trainee / Young investigator
350 Euros
490 Euros
580 Euros
Participant from a developing country
350 Euros
490 Euros
580 Euros
Nurse
200 Euros
250 Euros
300 Euros
Student
100 Euros
150 Euros
200 Euros
When you register, you will be charged the applicable fee on your registration date. Please note that the reduced registration fee will only apply for:
•
trainees / young investigators, i.e. doctors and researchers under 35 years of age. To be considered for this category, please attach a copy of your passport
•
participants from developing regions, as per the World Bank. To be considered for this category, please attach a letter of recommendation from your
employer verifying your work place with full contact details. Developing regions, as per the World Bank website, please click on one of the following links,
according to your location: EAST ASIA & PACIFIC (http://data.worldbank.org/region/EAP); EUROPE & CENTRAL ASIA (http://data.worldbank.org/region/ECA);
LATIN AMERICA & CARRIBEAN (http://data.worldbank.org/region/LAC); MIDDLE EAST & NORTH AFRICA (http://data.worldbank.org/region/MNA); SOUTH
ASIA (http://data.worldbank.org/region/SAS); SUB SAHARAN AFRICA (http://data.worldbank.org/region/SSA).
•
nurses will need to attach a proof of employment to their registration form to be considered for this category
•
students will need to attach a copy of their student ID card to be considered for this category
Registration entitlements
Participation in all scientific sessions
Full
delegate
Trainee or
young
investigator
Participant from
a developing
country
Nurse
Student
p
p
p
p
p
Entrance to the exhibition area
p
p
p
p
p
Participation in the opening ceremony
p
p
p
p
p
Conference materials
p
p
p
p
p
Coffee breaks
p
p
p
p
p
Lunch breaks
p
p
p
p
p
Certificate of attendance with CME credits
p
p
p
p
p
Payments. You can pay your registration fee by:
1. Making a bank transfer to the Conference Organiser using the details below.
2. Send your completed registration with a copy of your receipt/remittance slip attached
Ordering Customer Name:
Delegate Name:
Account Name: IBAN: SWIFT/BIC: Conference Code: VAT No:
(Enter payee name here)
(If different to above)
E I Congresses & Communications UK Ltd
GB35MIDL40051570681894 MIDLGB22 EiP2013
GB 943 8010 33
Cancellations and substitutions policy. Please note that an administrative fee will be applied on any cancellation of a completed
registration. In the unfortunate event of a cancellation, we will still help you reduce the damage through the policy shown here below.
Please note that all refunds will be processed two (2) months after the conclusion of the Conference. The size of the administrative
fee depends on how close to the event the cancellation is made. For written cancellations or alterations* received in 2013, the
administrative fees are as follows:
•
•
•
•
30 Euros for written cancellations or alterations* received before 4 September 2013.
80 Euros for written cancellations or alterations* received from 5 September 2013 to 2 October 2013.
50% of the registration value for written cancellations or 80 Euros for alterations* received from 3 October 2013 to 1 November
2013.
100% of the registration value for written cancellations or 100 Euros for alterations* received after 2 November 2013.
* In case of alteration, a completed Registration form must be submitted for the new (i.e. the substituting) delegate.
Registration form
Please use this registration form only if you cannot register online via
http://2013.excellence-in-paediatrics.org
•
•
•
•
This registration form is for 1 delegate only.
All requested sections must be completed before you can register.
Please use CAPITAL LETTERS only, and tick the boxes where appropriate.
Submit your completed registration form to eip@2eic.com or via fax to +44 (0) 208 326 5726, with
attention to The Registrations Department, EiC2 Ltd.
What type of delegate are you?
Full Delegate
Participant from developing country
Trainee/Young Investigator
Nurse
Student
What type of information took you to this registration form?
Please select all applicable by clicking in the corresponding boxes
Email from EiP, with a link + reminder to register
I was invited by an industry representative
My colleague or boss asked me to register
Information received at a conference
Advertised link in a medical publication
One of the EiP 2013 speakers notified me
Google or other search engine
Social media (Facebook, Twitter, etc.)
Publicly displayed poster advertisement
Newsletter article or advertisement
My medical association notified me
I already visited Excellence in Paediatrics
About you (please click once in the text box first, then type your name with the computer keyboard)
1. Last name
2. First name
3. You are a... Male
Female
4. You are a... Doctor
Professor
Other
Your contact details
5. Department
6. Organisation
7. Postal address
9. City
8. Post code
10. Country
11. Email
13. Fax
12. Mobile
Travel Agency contact details
(This section is to only be completed if you are a travel agency handling delegate registrations)
14. First Name
15.Last Name
17. Mobile
16. Email
18.Agency Name
Your safety is important to us. Please indicate a contact person in case of emergency
19. Last name
20. First name
21. Email
21. Mobile
Tell us about your work
22. What is your current work role ?
Please select all applicable
23. In what type of setting do you work ?
Please select all applicable
Nurse or midwife
Primary care (or any outpatient clinic)
Paediatrician in training/junior doctor
Secondary care (general hospital)
General Practitioner/family doctor
Tertiary care (children’s hospital)
General Paediatrician
Private practice
Paediatric specialist
Researcher and/or teacher
Other (industry, social, government, etc.)
Other
University
24. How many years of post-graduate training or work experience do you have in paediatrics ?
25. Do you need an invitation for a visa for Qatar
Yes
No
Check visa requirements for Qatar on the official website of The State of Qatar Ministry of Interior website:
http://www.moi.gov.qa/site/english/channel/Visitors/index.html
Billing Details
Contact person for billing, and billing address
26. Last name
27. First name
28. Department
29. Organisation
30. Postal address
32. City
31. Post code
33. Country
35. Tel
34. Email
37. Do you need an invoice to make a payment?
36. Fax
Yes
No
Important information. The Conference Organisers of the Excellence in Paediatrics reserve the right at
any time to change the programme or to cancel or postpone the Conference. In the event of cancellation
or postponement, their liability is limited to refunding any registration fee already paid. The Conference
Organisers will notify registered participants at the address shown on their registration form of any decision to
cancel or postpone. The Conference Organisers strongly recommend attendees take out their own insurance
against any losses arising from cancellation or postponement of the Conference or the inability of a participant
to attend for any reason whatsoever, and they accept no liability for any loss or damage suffered by any
participant or accompanying person or other person whatsoever. It should be noted that the data given in
this form will not be disclosed to any third parties who are not directly involved in the organisation of the
Excellence in Paediatrics nor will it be publicised in any other way.
Be a part of an International Paediatric Community - Become a Member
You are invited to become a member of the Excellence in Paediatrics Community and use our unique online
platform to:
•
•
•
•
•
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Upload your scientific profile
Connect with colleagues from around the world
Collaborate online and be a part of special interest groups to carry out collective tasks
Access online paediatric resources and share your materials with the rest of the community
Participate in clinical discussions through forums and blogs
Stay updated with the latest paediatric news
If you would like to become a member of the EIP Community, indicate your preference below and we will
create your online profile and send your login details via email.
No
Yes
38. I want to be a member of the Excellence in Paediatrics Community
I agree to the collection and processing of my personal data by EiC2, for the purpose of sending
information materials (newsletters) in relation to conferences with similar topics, as well as promotional and
advertising e-mails inaccordance with its advertising policy.
I hereby confirm that I have read and understood the registration terms as well as the cancellation and
substitution policy, which I accept without any reservations.
39. I do agree with the above statement about my personal data
Yes
No
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An original signature is required; no typing.