BIOETHICS, MEDICAL ETHICS & HEALTH LAW Towards the 21st ...

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12 Registration Form - Bioethics 2013To register online see: www.isas.co.il/bioethics2013Please type or print in block letters and return to Secretariat:Bioethics 2013, ISAS, POB 574, Jerusalem 91004, IsraelTel: +972-2-6520574, Fax: +972-2-6520558, email: register@isas.co.ilSurnameFirst Name......................................................................................................................................................................................................Place of Work......................................................................................................................................................................................................email......................................................................................................................................................................................................Full Mailing Address Home Work......................................................................................................................................................................................................Home Work......................................................................................................................................................................................................City, State Country Postal Code......................................................................................................................................................................................................Phone......................................................................................................................................................................................................Arrival DateFaxTime......................................................................................................................................................................................................AirlineFlight Number......................................................................................................................................................................................................AccommodationNo accommodation requiredPlease reserve a room at theRoyal Continental HotelNH Ambassador HotelRoom type: standard superior single double*Check in (date) Check out Total number of nights......................................................................................................................................................................................................I will share my room (if double occupancy) with*......................................................................................................................................................................................................* It is the sole responsibility of the participant to find a roommate. In the absenceof a roommate, single occupancy price will be charged.
Registration Form - Bioethics 201313Conference registration ...........................Accompanying person (Name.................................) ...........................Hotel accommodations ...........................Gala get-together dinner ............ seat(s) ...........................Farewell dinner & folklore evening ............ seat(s) ...........................Tours - Naples1. Walk with the KingsMonday, November 18 Thursday, November 211 Person: 60 2 People: 110 ...........................2. Step in the PastMonday, November 18 Friday, November 221 Person: 70 2 People: 130 ...........................3. Moonlight City TourMonday, November 18 Thursday, November 211 Person: 50 2 People: 90 ...........................Tours - Surroundings4. Pompeii and SorrentoSunday, November 17 Friday, November 221 Person: 150 2 People: 285 ...........................5. Caserta Royal PalaceMonday, November 18 Saturday, November 231 Person: 130 2 People: 250 ...........................Total: ...........................Payment InstructionsEnclosed is check payable to ISAS International Seminars.Charge my credit card: VISA DINERS M/C AMEX......................................................................................................................................................................................................NumberExpiration date3-4 Digit Security Code......................................................................................................................................................................................................Bank transfer to: ISAS International Seminars Ltd.Bank Leumi, Branch #687, 19 King David St., Jerusalem, IsraelAccount Number 9400/41SWIFT Account: LUMIILITIBAN Code: IL 79 0106 8700 0000 0940 041Please email/fax a copy of the bank transfer instructions to the secretariat.Name Signature Date......................................................................................................................................................................................................
Page 2 and 3: 2Invitation and Call for PapersThe
Page 4 and 5: 4General InformationConference Venu
Page 6 and 7: 6General InformationPayment:Payment
Page 8 and 9: 8Tours and Sightseeingof Piazza del
Page 10 and 11: 10 Tours and Sightseeingof Pietatel
Page 15: SecretariatISAS International Semin

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