IAA-Symposium - Registration

9^th IAA Symposium on Small Satellites for Earth Observation
April 8 - 12, 2013, Berlin, Germany

Berlin-Brandenburgische Akademie der Wissenschaften

ConTour GmbH Friedrichstraße 95 10117 Berlin Germany Fax. +49-30-2096 2133	9th IAA Symposium on Small Satellites for Earth Observation April 8 – 12, 2013 Berlin-Brandenburgische Akademie der Wissenschaften (BBAW) Germany
Status:	Full ParticipantStudentExhibitor
Title:	Prof.Dr.Mr.Ms.Mrs.
Surname:*
First Name:*
Company:*
Mailing Address:*
ZIP-Code - City:*
Country:*
Phone:
Fax:
E-mail:*

Be sure to fill out all the fields marked with an *.

Accompanying persons (do not attend the symposium)

No.	Surname	First Name
1
2

A. Registration

Registration Fee	By January 15, 2013	After January 15, 2013	Total
Participant	€ 550.00	€ 700.00	€
Student	€ 190.00	€ 190.00	€
Accompanying	Free	Free	Free
Sub Total (A.):			€

B. Social Events

Subjects	Date	Payment	Number of Persons	Total
IAA Dinner, Hotel Adlon	April 09	€ 120.00/person		€
Concert, Konzerthaus Berlin	April 10	The tickets in different categories will be available during registration
Sub Total (B.):				€

C. Hotel Reservation

Reservation
Arrival Date/Time :		Roommate's Name:
Check-in Date :		Check-out Date :

No.	Hotel	Room rate	Room Style	Number of Room(s)	Total
1	Berlin Hilton *) (5*-Hotel)	S: € 175.00 D: € 195.00 Breakfast: incl.	single double		€
2	NH Hotel Berlin Mitte *) (4*-Hotel)	S: € 107.00 D: € 128.00 Breakfast: incl.	single double		€
3	ibis Berlin City Hotel *)	S: € 79.00 D: € 99.00	single double		€
*) The Credit Card number is required.				Sub Total (C.):	€

The hotel accommodation will be provided on a first-come, first-served basis.

Should the desired hotel no longer be available please book me at hotel No. (two options)
1st option
2nd option

D. Social Events free of charge

Social Events	Date/Time	No. of Persons
Get-Together, BBAW	April 07, 2013 / 19:00
Reception, Forum Adlershof	April 08, 2013 / 19:00
Visit News Schoenefeld Airport	April 12, 2013 / 09:30

E. Program for accompanying persons (to be paid onsite at the registration desk)

Tour	Date	Payment	Number of Persons	Total
Sightseeing tour Berlin	daily	€ 20.00 / person		€
City Circle Tour Berlin	daily	€ 22.00 / person		€
Sightseeing by ship	daily	€ 11.00 / person		€
Tour to Potsdam	daily ex. Mon.	€ 39.00 / person		€

Grand Total: (Sub Total A. + B. + C.) = €

Payment:

Credit card
Credit card :	American ExpressMaster CardVISA
Card number :
Date of Expiration :
Bank transfer
I have paid through :	bank transfer to ConTour GmbH
on Date :
the amount of :	payable in €
copy enclosed to :	Deutsche Bank, Berlin, Germany, Account No. 149 438 402, IBAN: DE93 100 700 240 1494384 02, Bank Code (BLZ): 100 700 24, BIC (SWIFT): DEUT DE DBBER, Reference: 9th IAA Symposium.
	Please make sure that the name(s) of participant(s) appear(s) on the bank transfer form.