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    Registration Form: 7th Young Psychiatrists' Network Meeting

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    andrej_prosev6866
    This document provides a registration form for the 7th Young Psychiatrists' Network Meeting being held on December 6-7th, 2018 in Catania, Sicily. The meeting will focus on "The gray zone: the transition from Child to Adult Psychiatry." The form requests information such as title, degree, contact details, accompanying persons, and payment details. Registration fees vary based on the registration date and professional status. Payment must be made before registration is confirmed and can be completed via bank transfer or credit card.

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    Registration Form: 7th Young Psychiatrists' Network Meeting

    Uploaded by

    andrej_prosev6866
    78 views3 pages
    This document provides a registration form for the 7th Young Psychiatrists' Network Meeting being held on December 6-7th, 2018 in Catania, Sicily. The meeting will focus on "The gray zone: the transition from Child to Adult Psychiatry." The form requests information such as title, degree, contact details, accompanying persons, and payment details. Registration fees vary based on the registration date and professional status. Payment must be made before registration is confirmed and can be completed via bank transfer or credit card.

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    Registration_form_third_version (1).docx

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    This document provides a registration form for the 7th Young Psychiatrists' Network Meeting being held on December 6-7th, 2018 in Catania, Sicily. The meeting will focus on "The gray zone: the transition from Child to Adult Psychiatry." The form requests information such as title, degree, contact details, accompanying persons, and payment details. Registration fees vary based on the registration date and professional status. Payment must be made before registration is confirmed and can be completed via bank transfer or credit card.

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Download as docx, pdf, or txt
    78 views3 pages

    Registration Form: 7th Young Psychiatrists' Network Meeting

    Uploaded by

    andrej_prosev6866
    This document provides a registration form for the 7th Young Psychiatrists' Network Meeting being held on December 6-7th, 2018 in Catania, Sicily. The meeting will focus on "The gray zone: the transition from Child to Adult Psychiatry." The form requests information such as title, degree, contact details, accompanying persons, and payment details. Registration fees vary based on the registration date and professional status. Payment must be made before registration is confirmed and can be completed via bank transfer or credit card.

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    © All Rights Reserved
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    7th Young Psychiatrists' Network Meeting

    December 6-7th, 2018, Catania, Sicily, Italy


    “The gray zone: the transition from Child to Adult Psychiatry”

    Registration Form
    Please fill out this form and e-mail to ypn2018italy@gmail.com

    A. PARTICIPANT’S DETAILS (please fill in capital letters)


    Title: 〇 Prof. 〇 Dr. 〇 Mr. 〇 Mrs. 〇 Other

    Degree: 〇 PhD 〇 M.D. 〇 Other

    Surname: ______________________ First Name: ___________________

    Institution: _____________________________________________________________

    Department: ___________________________________________________________

    Postal Address: ______________________________ Postal Code: ____________

    City/State: __________________________________ Country: _________________

    Telephone: __________________________________ Fax: _____________________

    e-mail: ______________________________________

    B. ACCOMPANYING PERSON’S DETAILS (please fill in capital letters)


    1st Accompanying person: 〇 Mr. 〇 Mrs. 〇 Child

    Surname: ____________________________ First Name: ________________________

    2nd Accompanying person: 〇 Mr. 〇 Mrs. 〇 Child

    Surname: ____________________________ First Name: ________________________

    C. REGISTRATION FEES
    Registration categories Early Registration Late Registration On-site
    Until November 1st, From 2nd
    2018 November
    until 5th December,
    2018
    Psychiatrists, Psychologists, 〇 182 euros 〇 200 euros 〇 220
    Other Mental Health euros
    Professionals
    High Income
    Psychiatrists, Psychologists, 〇 150 euros 〇 170 euros 〇 190
    Other Mental Health euros
    Professionals
    Low Income
    7th Young Psychiatrists' Network Meeting
    December 6-7th, 2018, Catania, Sicily, Italy
    “The gray zone: the transition from Child to Adult Psychiatry”

    Accompanying person 〇 65 euros 〇 80 euros 〇 90 euros


    Official Congress Italian dinner 〇 25 euros 〇 25 euros 〇 25 euros
    (Thursday 6th December, 2018)
    International Dinner 〇 35 euros 〇 35 euros 〇 35 euros
    (Friday 7th December, 2018)
    Total Cost _____________+ 22% IVA = ________________

    Important notes:
     The Early Registration Fee is applicable for registration and payment by November 1 st, 2018
     After November 2nd, 2018, the late registration fee will apply without further notice
     The Registration Fee should include an amount of +22% including IVA for fiscal purposes
     After the registration phase, you will be contacted by email by DUERRE CONGRESSI which will
    give you more details on methods of payment

    Registration Fee for participants include:


     Admittance to all congress sessions
     Admittance to the ehibition area
     Congress bag and material
     Certificate of attendance
     Welcome reception (6th December, 2018)
     International Night (7th December, 2018) with welcome drink
     2-days Coffee breaks
     2 Light lunches

    Registration Fee for Accompanying Persons include:


     Access to the Congress Area
     Welcome reception (6th December, 2018)
     International Night (7th December, 2018)
     2-days Coffee breaks
     2 Light lunches

    D. METHOD OF PAYMENT
     Registration will not be confirmed until full payment has been arranged
     Payment can be completed either by bank transfer or credit card
     Personal cheques and Eurocheques are not acceptable
     Bank transfer and credit card fees are paid by the participant
     After the registration phase, you will be contacted by email by DUERRE CONGRESSI which will
    give you more details on methods of payment
    7th Young Psychiatrists' Network Meeting
    December 6-7th, 2018, Catania, Sicily, Italy
    “The gray zone: the transition from Child to Adult Psychiatry”

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