Registration

Registration on 2 Nordic seminars
17 & 18 March 2009

Fields with asterics * are required

1. Personal information

Last Name*

First name*

Institution / Organization*

Address*

City*

Country*

E-mail*

Flight information.

Arrival date

Flight no.(if known)

Departure date

Flight no.(if known)

Special needs or requirements (vegetarian, allergy etc.)

Name(s) of accompanying person(s)

2. Seminars

A) Muligheter og barrierer

17 March

B) A Better Life through Healthier Choices

18 March

3. Accommodation

Hotel rooms have been reserved for conference participants at Hilton Reykjavik Nordica Hotel

All reservations are handled by Gestamóttakan. Possible changes of your hotel reservation must be made in writing to Gestamóttakan.

Please do not contact the hotel directly.

A credit card number will be required to secure the reservation. One night's accommodation will be charged for no-shows

Payment for accommodation and excursions should be paid through Gestamóttakan - Your Host in Iceland.

	Hilton Reykjavik Nordica Hotel (breakfast incl.)
	Single room	Double room
Standard	EUR 114	EUR 144
Plus	EUR 130	EUR 160
Sharing room with:
If two in room:	Double (double sized bed) Twin (two seperate beds)
	No accommodation required

4. Form of payment

Registration payment for the Seminar should be done by credit card (VISA or MasterCard).

Please indicate card number and expiry date when sending in credit card information

Visa
Mastercard/Eurocard

^*Credit card number: - - -

Expiration date: -

Signature on card:

*As this registration form is on an unsecure server participants can fill out only the first 12 digits and the expiry date, but send us the last 4 digits by e-mail to Þetta tölvupóstfang er varið gegn ruslpóstsþjörkum, Þú verður að hafa JavaScript virkt til að sjá það. . Participants can also give their credit card number by fax (+354) 551 1736.

For further assistance / information contact the conference organizers:
Gestamóttakan ehf - Your Host in Iceland
www.yourhost.is

Komdu á okkar fund

Gestamóttakan ehf
Kirkjutorg 6
101 Reykjavík
Sími: 551 1730, GSM: 692 1730
gestamottakan@gestamottakan.is