Pay for the C.L. Davis Foundation, European Division Pathology Symposium in Leon, 2012 by euro cheque

REGISTRATION FORM
Lunch, coffee and tea etc will be provided each day.
No of persons euros
Registration Fees
Members: 340 euros ....... .........
Non-members: 390 euros ....... .........

TOTAL
Cheques should be made payable in euros to
CL Davis DVM Foundation or pay online at www.eurocldavis.net

Please give your telephone number, fax number,
e-mail address and indicate whether you have any
special dietary requirements. Please send to the conference organiser.
__________________________________________
First name:
Last name:
Academic degrees:
__________________________________________
Full postal address:




__________________________________________
Tel:_______________________________________
Fax:_______________________________________
Email:_____________________________________

Special dietary requirements:___________________

Please make all remittances payable in euros to:
“CL Davis DVM Foundation”
Return to:
Conference Organiser
Professor Sean J Callanan
UCD School of Veterinary Medicine
University College Dublin
Belfield
Dublin 4
Ireland
Tel: 00353 1 7166152
Fax: 00353 1 7166157
Email: sean.callanan@ucd.ie