Please fill out this form online and press
the 'Submit' button, or PRINT, fill out in BLOCK LETTERS and FAX
or AIRMAIL together with your payment, to Secretariat's address:
INTERNATIONAL ACADEMY OF CARDIOLOGY
15th WORLD CONGRESS ON HEART DISEASE
ANNUAL SCIENTIFIC SESSIONS 2010
PO Box 17659, Beverly Hills, CA 90209, USA
Tel: +1 310 657 8777
Fax: +1 310 659 4781
Please complete this section accurately. The information you
provide will allow us to correspond with you efficiently.
marked with (*) are required.
Please check the appropriate box/s:
* letter of
** valid student card required
Fees for PARTICIPANTS include: participation in all
scientific sessions, Congress kit, program, abstract book,
printed material of the Congress and invitation to Get-Together
The Social Program for all participants is:
Saturday, July 24, 2010 at 18:30 Get Together
Cost for Accompanying Person is US$ 45
Monday, July 26, 2010 at 20:00 Farewell Dinner (optional)
Cost is US$ 95
You can purchase these tickets upon your arrival at the Congress
For information and booking of tours, you will be able to
contact the hotel front desk all times.
Please indicate the amount enclosed and preferred mode of
Please ensure that you send your fully completed Registration
form together with your payment:
Credit Card - Payments
will be charged in US$ according to the rate of exchange to the
Euro on date of payment.
Please note that you must fill out all the boxes under this
section if you are paying online by credit card.
printed form only)
Bank Transfer -For further
information regarding a bank transfer, please contact the
Cheque made payable to: International
Academy of Cardiology
Enclosed cheque number: _______________ Bank:
Please include fully completed registration form.