The 4th Scandinavian Translational Pathology Seminar, in Bergen, October 23-24 2019

Name Name First Last
Red star=required /mandatory information.
Nationality

Our hotel is obliged to register their guests' nationality.
Position/title

Your position or title (or if a student: whether you are a master student, PhD student or other)
Department

What department you belong to at your university/place of work.
Institution/Organization

The name of the university/hospital/organization where you work or study.
Mobile phone

A phone number where we can reach you also during the symposium.
Email

Your e-mail address.
Please indicate ALL parts you will participate in.

Please indicate ALL parts you will participate in. October 23rd, Seminar day 1 October 23rd, Lunch October 23rd, Dinner October 24th, Seminar day 2 October 24th, Lunch

You can tick several boxes. Tick all the boxes if you will participate in both events, throughout.
Do you need hotel accommodation?

Do you need hotel accommodation? No, I do not need a hotel room. Yes, I need hotel room October 23rd to 24th (during the seminar) I also need a hotel room October 22nd-23rd, (before the seminar). Additional 1620 NOK. I want dinner on October 22 (served until 21.00), Additional 460 NOK for a 3 courses
I want to/am willing to share my hotel room with the following person/persons
Please describe any allergies or needs you have with regards to foods or beverages:

If you don't have any allergies or special requirements, you don't need to write anything here.
Payment

Payment I wish to pay at the hotel/My funds are located outside of the UiB My funds are located at the UiB and I want an "internal UiB invoice"

The own contribution is NOK 2500,-. This rate is subsidized.
INVOICING
-If you funds are at the UiB, please write stedkode+project number & activity/analyse-nummer.
-If your funds are outside of the UiB, please enter invoice Address and invoice reference/Merida number if relevant

Please be as detailed as possible. The own contribution is NOK 2500,-. This rate is subisdized.
Economy contact person, email, phone number

The contact information for the person handling the finances for your group in your organization's administration. UiB employees/students should also add department number (stedsnr).
STAND
Commercial companies can have a stand to present their products & services. Please write your specific needs (table, power etc etc) onto the "Anything else you want to inform us about" box below.

STAND
Commercial companies can have a stand to present their products & services. Please write your specific needs (table, power etc etc) onto the "Anything else you want to inform us about" box below. Yes, I want to have a stand
POSTER PRESENTATION
A one page poster abstract in Word format needs to be submitted to Eli.Vidhammer@uib.no within October 15 for inclusion in the poster book

POSTER PRESENTATION
A one page poster abstract in Word format needs to be submitted to Eli.Vidhammer@uib.no within October 15 for inclusion in the poster book I want to present a poster

If you will NOT be presenting poster, you can skip all questions pertaining to posters.
Will there be more than 1 person to present the poster? If yes, indicate name(s).

Both (or all) of you might tic the box that you wish to present poster, but indicate the name(s) of the other(s) so that we know it is one and the same poster (cross-reference each other).
Poster title
Authors
Preferable poster format: Portrait H120 x W85. However, your are welcome to use larger posters if they are already printed. If your poster has a larger height or width than our preferred format, you are required to specify its dimensions (height and width) below.
Anything else you want to inform about?

Anything else you think we should know?