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REGISTRATION FORM
40th Annual Meeting of The Egyptian Urological Association in conjunction with The European Association of Urology

December 7– 11, 2005
Sharm El Sheikh, Egypt

For Office Use Only
Reg.No
By
Date
PLEASE COMPLETE AND RETURN THIS FORM ALONG WITH YOUR PAYMENT TO:

EUA OFFICE, Congress Secretariat
33 Ramsis St., Marouf Tower (B), Floor 14 Phone: ++20-2-5776717 or ++20-2-5780588
Cairo 11111, Egypt Fax: ++20-2-5780588
  Email: eua@uroegypt.com ; heba-eua@uroegypt.com
  Web site: www.uroegypt.com
Please TYPE or PRINT in BLOCK letters.

EUA Member                  Non-Member                   Resident

 Last Name              First Name  

Title:   Prof.   Dr.   Mr.   Mrs.   Ms.

Department             Institution  

City              Country  

Mailing Address:

No.             Street  

City              Country:  

Phone              Fax  

Email  

Accompanying Person(s)*

Last Name              First Name  

Last Name              First Name  

Arrival Date            Departure Date   

* Accompanying persons are not entitled to attend scientific sessions

Registration Fees

  Early:
before Aug. 31 		Late:
before Oct. 30 		On Site*: after Oct. 30 Amount due
EUA Member Free of Charge USD. 100 USD. 150 USD.
Non-Member USD.200 USD.250 USD.300 USD.
Accompanying Person        USD.50 USD.60 USD.70 USD.
Resident** Free of Charge USD.75 USD.125 USD.

  • *All registrations received after August, 2004 will be considered onsite registrations.

  • * Max.35 years old. A letter from the department has to be attached to this registration form.

  • Early registration should be accompanied by one night hotel deposit (non - refundable).

  • No personal cheques are accepted
    •

    Hotels

     ROOM TYPE Single Room Double Room Triple Room
    HOTEL NAME Egyptian Non- Egyptian Egyptian Non- Egyptian Egyptian Non-Egyptian
    PYRAMISA L.E.330 USD.80 L.E.440 USD.120 L.E.590 USD.150
    HOLIDAY INN L.E.320 USD.75 L.E.385 USD.100 L.E.545 USD.120
    Movenpick Golf L.E.440 USD.110 L.E.600 USD.145 L.E.825 USD.200
    CATARACT LYALYNA L.E.290 USD.50 L.E.400 USD.80 L.E.520 USD.110

  • The above rates for room based on half board (H.B.)
  • Final deadline for Hotel reservation: Sept. 31, 2005
  • Payment: Hotel deposit 1 night per room should accompany this form
  • A one night hotel deposit (non-refundable) has to be sent with registration.

    •  


                                               

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