1. Complete Name :

2. Birth date :

3. Profesion, ocupation :

4. Specialty and Profesional degree:

5. Working place and its complete address, including e-mail, phone and fax numbers:

6. Coresponding address, including e-mail, phone and fax numbers:

7. In order to be fully registered to the event I paid the total sum of ........ Eur, as:

- Congress fee: 50 Eur/person

- participation to the "Romanian evening dinner" (25 Eur/person)

- Post-Congress Workshop fee: 90 Eur/person

through wire transfer / international money order
- number and date of money transfer document .... ..............

The payment was made by (name of institution / company or physical person that made the payment): .....................

for (name of participant):...................... to the bank account of the Romanian Apitherapy Society.

8. I will join the group that will make on October 31-St. (Sunday afternoon) the visit to the Parliament House (the second largest building in the world with over 3013 rooms!): Yes / No

The cost of the visit will be calculated according to the number of participants; the final registration and payment for the trip need to be made latest on Saturday morning, October 30-th. to the Congress secretariat in order to give the organizers enough time to prepare the bus, the route, etc. in due time.

Please send us all your answers to the above registration form, through a Word document, at: secretariat@apiterapie.ro

Important ! All speakers, authors and co-authors of the oral presentations and/or posters will have free access to the Api-Expo and to the Congress (conferences) room so they do not need to pay any Congress fees, except for the "Romanian evening" (Saturday, October 30-th.) and the post-Congress workshop (November 01-St.).