4th Franz-Volhard-Symposium - 1997

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"Differentiation in the Cardiovascular System",
June 27-28, 1997, Franz-Volhard-Klinik, Berlin-Buch

Registration form

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Please complete and fax to:
Virchow-Klinikum
Franz-Volhard-Klinik
Attn. Susanne Meißmer	Tel. ++49/(0)30/9417-2203
Wiltbergstr. 50	Fax ++49/(0)30/9417-2206
D-13122 Berlin	E-mail: [email protected]

Last Name........................................................

First Name(s)....................................................

Institute........................................................

Department.......................................................

Street...........................................................

Zip code / City..................................................

Country..........................................................

Phone............................................................

Fax..............................................................

E-mail...........................................................

	Full registration DM 250
	Students (proof required) DM 50
	I included a cheque payable in DM made out to "4th Franz-Volhard-Symposium".
	I transferred payment in DM (free of any bank transfer charges) to: Franz-Volhard-Klinik Bank: Berliner Sparkasse Bank Code: 100 500 00 Account No. 20 500 055 15 Code: 4th Franz-Volhard-Symposium (954 47 20) and participant's name!!!

Social activities:

	I am attending the Boat tour on the river Spree with dinner (June 27, 1997).
	I am attending the Farewell dinner (June 28, 1997).

Accompanying person:	.......................................................
Date:	.......................................................
Signature:	.......................................................

Registration Fee includes scientific program, coffee breaks, lunches, boat tour on Friday night, fare-
well dinner on Saturday evening, and shuttle busses to the Franz-Volhard-Klinik (if required).
Accomodation: No rooms have been reserved for this symposium. Please contact the hotels directly to
make your reservations.
The number of participants is restricted to 100. Early application ensures participation.
First come - first serve!
Deadline of registration: May 30, 1997