15th World Congress on Heart Disease

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

Participant's Identification
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Registration Fees
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	from February 1 - June 25, 2010	from June 26 - July 20, 2010	after July 21, 2010
Participant	US$ 640	US$ 720	US$ 760
Nurse, Technician, Trainee, Student*	US$ 495	US$ 540	US$ 595
Farewell Dinner (optional) number of Farewell Dinners:	US$ 95
Get-Together Reception cost for Accompanying Person(s) number of Get-Together Reception	US$ 45
Total Fees

* letter of verification required
** 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 Reception.

The Social Program for all participants is:

Saturday, July 24, 2010 at 18:30 Get Together Reception
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 Registration Desk.
For information and booking of tours, you will be able to contact the hotel front desk all times.

Payment
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Please ensure that you send your fully completed Registration form together with your payment:

Option 1:
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.

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Option 2:
Bank Transfer -For further information regarding a bank transfer, please contact the Secretariat.

Option 3: (with printed form only)
Cheque made payable to: International Academy of Cardiology
Enclosed cheque number: _______________ Bank: _______________________________
Please include fully completed registration form.

CANCELLATION POLICY 50% refund on registration fees is applicable if written cancellation received before May 11. 25% refund on registration fees is applicable if written cancellation received before July 10 After July 10 no refund available. Date: ____________ Signature: ____________