Animal Conference 2006 - Registration

(Please send one form per person:
VEREIN GEGEN TIERFABRIKEN, Waidhausenstr. 13/1, 1140 Vienna, Austria) or
fax +43 1 9291498-2

Title	______________________________________________
First name	______________________________________________
Surname	______________________________________________
Organisation	______________________________________________
Address	______________________________________________
City	______________________________________________
Postcode	______________________________________________
Country	______________________________________________
Phone/Fax	______________________________________________
Email	______________________________________________

Registration details:

Saturday 14.10.2006	€	0,-
Sunday 15.10.2006	€	0,-
____ x middaybuffet (á € 9,50) (maximum = 2, saturday and sunday)	€	____
____ x evening meal (á € 8,00) (maximum = 1, saturday only)	€	____

Total	€	____

Payment

I will pay when I check in on saturday morning (14.10.2006) or submit the money to the following bank account (please fill in your complete name and as reason for transfer "Animal Conference Vienna 2006"!):

VEREIN GEGEN TIERFABRIKEN, 1140 Wien
Kto. 92 029 958, P.S.K. (Blz. 60000)
IBAN: AT766 000 000 092 029 958, BIC: OPSKATWW

Comment


Date:___________	Signature:__________________________________