GENERAL INFORMATIONCONGRESS LOCATIONPalais des Congrès de Paris2, place de la Porte Maillot, 75017 Paris - www.palaisdescongres-paris.comFor more than 30 years, the Palais des Congrès de Paris has largely contributed to make the city the world capital ofinternational congresses. It is located at the Porte Maillot, at a few minutes walking distance of the "Gold Triangle":Champs Elysées, Place de l’Etoile, rue du Faubourg Saint-Honoré... More than ever, the Palais des Congrès de Parisis the ideal place of meetings of scale.AIR TRANSPORTATIONREFERENCE TO BE QUOTED: AXZE SE 6525Validity: from 08/10/<strong>2006</strong> to 20/10/<strong>2006</strong>- On international routes. Discounts registered under GGAIRAFEVENTNEGO. On presentation of this original document, Air France offices throughoutthe World will offer you preferential fares (suject to conditions) from your country of departure on the regular full fare in business or economy class foryour round-trip journey to attend this event. Your nearest Air France office: www.airfrance.com- On the domestic network within metropolitan France. Discounts registered under GGAIRAFCONGRES. This original document will entitle you toa rebate of up 45% (subject to conditions) on the regular full fare in economy class for your round-trip journey on the Air France metropolitan domesticnetwork to attend this event. To book and obtain your electronic ticket within France, contact 0 820 820 820 (0,12 €/min) or your travel agent inmetropolitan France or your Air France office. Your nearest Air France office in France at: www.airfrance.frThis document mandatory to issue the ticket will be required at any point of the journey to justify the fare.Members of Air France’s partner-carriers will receive “miles“ on their loyalty programme when using Air France flights. Check details with your Air France office.TRAINA discount rate of 20 to 25% of the basic fare, valid for all services under SNCF pricing system, in 1st or economic class corresponding tothe standard level 1 fare charged on TGV services and the fare applicable to other train services, exclusive of any reservation charges orsupplements. The voucher ticket has a two-week validity and shall include at least one day of the congress within this two-week period.Please ask the Congress Organization for vouchers (see registration form).LANGUAGESOfficial languages: French / English.Simultaneous translation in French, English, Spanish in all rooms (except Spanish in rooms 241 and 242 AB).HOTELSA number of rooms close to the Palais des Congrès has been booked especially for the delegates, to negociated prices, through our partner ConferenciaTravel.The number of rooms is limited; we recommend you to book your room as soon as possible and before September 20, <strong>2006</strong> by sending the hotelform to <strong>EuroMediCom</strong> or by making your reservation on line. Beyond this date, booking will depend on availability.On-line reservation is available at www.euromedicom.comInformations hotels : Tél : +33 (0)1 45 55 85 30 – E-mail : hotels@conferenciatravel.comFor any change or cancellation, contact Conferencia Travel (special rates available only through Conferencia Travel)Booking cannot be processed without total prepayment.Metro - Distance to Congress Single Double / Twin• MÉRIDIEN ETOILE**** Porte Maillot 260 € 270 €81 boulevard Gouvion Saint Cyr 75017 PARIS In front• CONCORDE LA FAYETTE**** Porte Maillot 215 € 225 €3 Place du Général Koenig 75017 PARIS On site• BEST WESTERN PREMIER PERGOLÈSE**** Porte Maillot 210 € 220 €3, rue Pergolèse 75016 PARIS 5 min walk• NEUILLY PARK*** Les Sablons 150 € 165 €23, rue Madeleine Michelis 92200 NEUILLY 7 min walk• HARVEY*** Porte Maillot 145 € 155 €7 bis, rue du Débarcadère 75017 PARIS 3 min walk• MAC MAHON*** Charles de Gaulle Etoile 145 € 160 €3, avenue Mac Mahon 75017 PARIS 5 min by metro• VILLA DES TERNES*** Porte Maillot 145 € 160 €97 avenue des Ternes 75017 PARIS 2 min walk• BEST WESTERN RÉSIDENCE IMPÉRIALE*** Porte Maillot 140 € 150 €155 avenue Malakoff 75116 PARIS 3 min walk• BEST WESTERN VICTOR HUGO*** Victor Hugo 140 € 160 €19, rue Copernic 75016 Paris 15 min by bus• STAR ETOILE*** Argentine 140 € 150 €18 rue de l'Arc de Triomphe 75017 PARIS 10 min walk• PALMA*** Porte Maillot 130 € 150 €46 rue Brunel 75017 PARIS 5 min walk• AMBASSADE** Boissière 90 € 105 €79, rue Lauriston 75116 PARIS 10 min by metro• PACIFIC** Dupleix 69 € 80 €11, rue Fondary 75015 PARIS 20 min by metroAll pricesin € (euros)includingtaxes andbreakfastREGISTRATION FEES Before Sept. 30 th <strong>2006</strong> After Sept. 30 th <strong>2006</strong> Delegate- 3 days ............................................................................................................................................................ 430 € ............................ 490 €- 1 or 2 days (day rate) .............................................................................................................................. 170 € / day .................. 200 € / day- delegate already registered to the AAMS Seminar or to the Pre-Course Face & Body .............................. 330 € ............................ 390 € Member of Association* or Scientific Society* with certification only*National and International Societies of Anti-Aging, Aesthetic Medicine, Cosmetic Surgery, Dermatology, etc.- 3 days ............................................................................................................................................................ 380 € ............................ 450 €- member already registered to the AAMS Seminar or to the Pre-Course Face & Body................................ 300 € ............................ 370 € Student, Nurse, Allied-Health, Physiotherapist with certification only- 3 days ............................................................................................................................................................ 330 € ............................ 390 €- 1 or 2 days (day rate) .............................................................................................................................. 120 € / day .................... 150 € / day- student, nurse already registered to the AAMS Seminar or to the Pre-Course Face & Body ...................... 280 € ............................ 340 € Accompanying person (access to exhibit and aesthetic workshops only)- 3 days ............................................................................................................................................................ 240 € ............................ 280 €- 1 or 2 days (day rate) .............................................................................................................................. 100 € / day .................... 120 € / day Aesthetic Pre-Course FACE & BODY (October 11 and 12 at le Cap 15 - Paris 15)- Delegate 2 days ............................................................................................................................................ 850 € ............................ 950 €- Member of Association of Scientific Society 2 days .................................................................................... 750 € ............................ 850 €- Student, Nurse, Allied-Health 2 days .......................................................................................................... 650 € ............................ 750 €- 1 day (day rate) ........................................................................................................................................ 450 € / day .................... 550 € / dayRegistration fees include access to all sessions (except for accompanying persons), workshops and commercial exhibit, coffee breaks, lunches andcocktails offered on site, a certificate of attendance, the conference book, a congress bag and all related documentation.
Family Name / Nom :First Name / Prénom :Specialty / Spécialité :Address / Adresse :<strong>EMAA</strong> <strong>2006</strong>, Paris October 13-15, <strong>2006</strong>Registration form - Fiche d’inscriptionZip code / Code postal : City / Ville :Country / Pays :Tel. : Fax :E-mail :Please type in capital lettersEn lettres capitales SVPREGISTRATION FEES / Droits d’inscriptionInclude access to all sessions, workshops and commercial exhibit, coffee breaks, lunches and cocktailsoffered on site, a certificate of attendance, the conference book, a congress bag and all documentation. Delegate / Congressiste3 days / 3 jours X 13/10 X 14/10 X 15/10 430 € 490 €Delegate also registered to 1 pre-course / Congressiste inscrit à 1 pré-cours 330 € 390 €2 days / 2 jours 13/10 14/10 15/10 Please tick the day(s) 340 € 400 €1 day / 1 jour 13/10 14/10 15/10 } Cochez le(s) jour(s) 170 € 200 € Member of Scientific Society (certificate requested)Membre d’une Société Scientifique (attestation à joindre obligatoirement)3 days / 3 jours X 13/10 X 14/10 X 15/10 380 € 450 €Member also registered to 1 pre-course / Membre inscrit à 1 pré-cours 300 € 370 € Student, Nurse, Physiotherapist, Assistant (certificate requested)No registration will be validated without certificate or proofEtudiant, Infirmière, Kiné, Assistante (attestation à joindre obligatoirement) Aucune inscription ne sera validée sans l’envoi d’une attestation3 days / 3 jours X 13/10 X 14/10 X 15/10 330 € 390 €Student, RN registered to 1 pre-course / Etudiant, Infirmière inscrit à 1 pré-cours 280 € 340 €2 days / 2 jours 13/10 14/10 15/10 240 € 300 €1 day / 1 jour 13/10 14/10 15/10 Cochez le(s) jour(s) 120 € 150 € Accompanying Person (access to exhibit only + workshops)Accompagnant(e) (accès à l’exposition seulement + workshops)3 days / 3 jours X 13/10 X 14/10 X 15/10 240 € 280 €2 days / 2 jours 13/10 14/10 15/10 200 € 240 €PRE-COURSES1 day / 1 jour 13/10 14/10 15/10 Cochez le(s) jour(s) 100 € 120 € AAMS - Anti-Aging Medicine Specialization - 6-day Seminar Venue: CAP15 - 3 Quai de Grenelle 75015 PARIS6 days / 6 jours X 7/10 X 8/10 X 9/10 X 10/10 X 11/10 X 12/10 1650 € 1750 €Day rate / Prix/jour 7/10 8/10 9/10 10/10 11/10 12/10 300 € x ... day(s) = .......... €Tick the day(s) and multiply by the day rate / Cochez le(s) jour(s) et multipliez par le tarif jour Aesthetic Pre-Course FACE AND BODY (lunches included)Student Member Non Member Student Member Non Member2 days / 2 jours X 11/10 X 12/10 Venue: CAP15 - 3 Quai de Grenelle 650 € 750 € 850 € 750 € 850 € 950 €1 day / 1 jour 11/10 12/10 75015 PARIS 450 € 550 € AAMS WRITTEN EXAMINATION (for the AAMS delegates in 2nd cycle - October 13, 11.00 am/1.00 pm) 550 € MEMBERSHIP WOSAAM 1 YEAR (150 € for individual member - Free for Scientific Societies or Associations) 150 € SUBSCRIPTION JEAAM (Journal of European Anti-Aging Medicine) - 1 Year (4 issues) 100 €PAYMENT / Paiement des droits d’inscriptionPlease find enclosed the total payment of / Veuillez trouvez, ci-joint, mon règlement total de :Total : .......................... €Bank check in € to Euromedicom / Chèque en € à l’ordre d’Euromedicom Bank transfer in € to Euromedicom / Virement bancaire en € en faveur d’Euromedicom☛ In case of payment by bank transfer, please add 15 € to the total fees (bank charges) / En cas de paiement par virement bancaire, merci d’ajouter 15 € au montant total (frais bancaires)☛Please tick the day / Cochez le jourPaying bank: HSBCAddress: 10 bis ave Gabriel Peri - F-95100 ArgenteuilAccount holder: Euromedicom sarl Credit card / Carte de crédit : Visa Eurocard/Mastercard American Express Diners ClubCard number / N° de carte : Card holder’s name / Nom du porteur : ________________________________________________Expiry date / Date d’expiration}}Please tick the day(s)Please tick the day(s)Bank code: 30938Branch code: 00051Account number: 00106040002Key digits: 01Early registrationbefore / avant30 September <strong>2006</strong> 3 digits code / Cryptogramme : Late registration after / après30 September <strong>2006</strong>and on-site / et sur placeNo registration will be validated without certificate or proofAucune inscription ne sera validée sans l’envoi d’une attestationIBAN : FR 76 3093 8000 5100 1060 4000 201BIC - SWIFT : LUBPFRPPThe payment transfer form should clearly state the name(s) of the delegate(s) and the reference “<strong>EMAA</strong> <strong>2006</strong>”Précisez le nom du ou des congressiste(s) et la référence « <strong>EMAA</strong> <strong>2006</strong> » sur les documents bancairesSignature :CANCELLATION POLICY / ANNULATION• Before 30 September <strong>2006</strong>: refund -10% / Remboursement -10 %• Between 30 Sept. <strong>2006</strong> and 10 October <strong>2006</strong>: refund -30% / Remboursement -30 %• After 10 October <strong>2006</strong> : no refund / pas de remboursement I would like to receive .... train reduction coupons / Je souhaite recevoir ... coupons de réduction SNCF I would like to receive an official letter of invitation (Visa formalities) / Je souhaite recevoir une lettre officielle d’invitation pour l’obtention de VisaPlease fill 1 FORM PER PERSON and send to / Compléter 1 BULLETIN PAR PERSONNE et le renvoyer à :<strong>EuroMediCom</strong> - 29 boulevard de la République - 92250 La Garenne-Colombes - FranceTel : +33 (0)1 56 837 800 - Fax : +33 (0)1 56 837 805 - Email : world@euromedicom.comRegistration on line with secured credit card payment / Inscription en ligne avec paiement sécurisé www.euromedicom.com