REGISTRATION

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Second International
EuroEpiStem: European Epigenomics & Stem Cells-2011 Meeting
                           ’Epigenomic Programming & Stem Cells for Drug Discovery’
Venue: Hotel IBIS PARIS PORTE DE BERCY
2, Place de l'Europe CHARENTON LE PONT 94220, Paris, FRANCE
            November 21 - 22, 2011

REGISTRATION  FORM

GeneExpression Systems, Inc. P.O. Box 540170, Waltham, MA 02454-0170 USA

Register the following Industry delegate(s) for this conference:  Euros € 848 or US $1098____
Register the following Academia/Government delegate(s):       Euros € 548 or US $698______
Register the following PhD students: (fax a copy of your id)      Euros € 328 or US $398______
REGISTRATION COSTS INCLUDES: Break refreshments for two days, but NOT Room accommodation
Poster presentation (Abstract handling fee)                                 Euros € 75 or US $100______
LATE FEE:
Registration Charges from October 5 to October 20:                   additional Euros €  48  or US $  50
Registration Charges from October 21 to November 4:                additional Euros €  82  or US $ 100
Registration Charges from November 5 to November 20:            additional Euros € 118 or US $ 150
On site Registration (November 21-22):                 additional Euros € 154 or $200               
                          
OPTIONAL: A New hardcover text (2010) from Springer Press, on “Stem Cells & Regenerative Medicine”
Edited by K. Appasani & R. K. Appasani, Forwarded by Sir John Gurdon  
 Check if you need a copy____US $180.00
OPTIONAL: A hard cover text (2011) from Cambridge University Press on “Epigenomics: From Chromatin
Biology to Therapeutics” Edited by K. Appasani        Check if you need a copy ____US $200.00

Name (print first, then last): _________________________________________________________
Title/Designation:                     ______________________________________________________________

Company/Institution: _______________________________________________________________

Address: _________________________________________________________________________

City/State/Zip Code/Country: ________________________________________________________

E-Mail:              ____________________________________________________________________

Phone:  __________________________________  Fax: ____________________________________
Payment Method:
Check enclosed:  _____ CHECKS CAN BE WRITTEN IN EITHER:   US $   or   UK ₤   or   Euros € and
Bill my company ______  Mail to: PO Box: 540170, Waltham, MA 02454-0170, USA

Charge my credit card: (check one) TRANSACTIONS WILL BE PROCESSED IN US DOLLAR CURRENCY
AmEx_____Visa_____MasterCard_______Discover______            
                                                                                                Billing Address (If different than the above)
Card Number: ______________________________________Security Code # (front/back on card):_______

Expiration Date:  ____________________________________Street:___________________________

Name (as shown on card):  ____________________________City/Country:_____________________

Signature of the cardholder _______________________Zip Code:______________________

How did you hear about this meeting?
Ad in Journal (circle):  Science, Nature, Cell, New-Scientist, Stem Cells, Stem Cells & Dev, Tissue Engineering,
 GES-Email Alert__, GES website__, Poster __, Post Card _, Brochure__, Other Web Ad_ , Referral __.

Substitutions/Cancellation Policy:
In case if your schedule prevents you to attend after registration we will accept a substitute colleague from your company at any time at no charge. However, we have to be notified in advance to prepare badges etc.

Cancellations before 90days: 70% refund
Cancellations before 60days 50% refund
Cancellations before 30 days NO REFUNDS