IAA-Symposium - Registration

12^th IAA Symposium on Small Satellites for Earth Observation
May 06 - 10, 2019, Berlin, Germany

Berlin-Brandenburgische Akademie der Wissenschaften

ConTour GmbH Friedrichstraße 95 10117 Berlin Germany Fax. +49-30-2096 2133	12th IAA Symposium on Small Satellites for Earth Observation May 06 – 10, 2019 Berlin-Brandenburgische Akademie der Wissenschaften (BBAW) Germany
Status:	Full ParticipantStudentExhibitor
Title:	Prof.Dr.Mr.Ms.Mrs.
Surname:*
First Name:*
Company:*
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ZIP-Code - City:*
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Phone:
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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 31, 2019	After January 31, 2019	Total
Participant	€ 600.00	€ 700.00	€
Student	€ 190.00	€ 190.00	€
Accompanying	free	free
Sub Total (A.):			€

B. Social Events

Subjects	Date	Payment	Number of Persons	Total
IAA Dinner	May 07	€ 120.00/person		€
Berlin Philharmonie - W. A. Mozart - Anton Bruckner	May 09	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: € 159.00 D: € 179.00 Breakfast: incl.	single double		€
2	NH Hotel Berlin Mitte *) (4*-Hotel)	S: € 129.00 D: € 154.00 Breakfast: incl.	single double		€
3	Motel One Berlin Spittelmarkt *)	S: € 90.50 D: € 123.00 Breakfast: incl.	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	May 05, 2019 / 19:00 - 20:00
Reception, Boat Tour	May 06, 2019 / 19:00 - 22:30
Excursion	May 10, 2019 / 09:00 - 13:00

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

Tour	Date	Payment	Number of Persons	Total
City Circle Tour Berlin	daily	€ 20.00 / person		€
Tour to Potsdam	daily ex. Mon.	€ 39.00 / person		€

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

Payment:

Credit card payment
Credit card :	American ExpressMasterCardVisa
Card number :
Date of Expiration :
Proof No :
Bank transfer
I have paid through :	bank transfer to ConTour GmbH
on Date :
the amount of :	payable in €
copy enclosed to :	Deutsche Bank PGK, Berlin, Germany IBAN: DE93 1007 0024 0149 4384 02 BIC (SWIFT): DEUTDEDBBER Reference: 12th IAA Symposium, name of participant
	Please make sure that the name(s) of participant(s) appear(s) on the bank transfer form.

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