I. Personal Details. II. Registration fees (Please mark with a cross)

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1 Registration form for the meetings of the 3 rd Annual and the 9 th ALPD (Please send your registration form via electronically to Name: Institution: Street: Country: Phone: I. Personal Details City: Postcode: Invoice address (if different from personal details) Name: Institution: Street: Country: City: Postcode: II. Registration fees (Please mark with a cross) ALPD 2014 symposium November, 2014 Before/on 7 November After 7 November Junior (<30 years, separate room) Junior (<30 years, shared room with other delegate) Please give the name of your room mate if known: Senior (>30 years, separate room) Senior (>30 years, shared room with other delegate) Please give the name of your room mate if known:.. Accompanying person We assume that the accompanying person will be in the same room with the delegate. If not please contact us.

2 Registration fees (ALPD) for participants covers the following: transport from/to Budapest Ferenc Liszt Airport 3 nights (21, 22 and 23 Nov) accommodation in the conference hotel (Hotel Novotel****) admission to all scientific sessions conference materials (including programme leaflet, badge, etc.) coffee breaks and lunches social events The registration fee for accompanying persons covers the following: free transport from and to Budapest Ferihegy Airport, lunches and social events meeting - 21 November, 2014 Before/on 7 November After 7 November If registered for ALPD symposium too If NOT registered for ALPD symposium Accompanying person who registered for ALPD conference can attend FREE of charge Accompanying person NOT registered for ALPD If you need ACCOMMODATION before and/or after the meeting, please mark the nights with a cross (if you registered to ALPD you do not need to cross 21 Nov, since it is already included): Separate room ( 75/night/person) Shared room ( 50/night/person) 20 Nov 21 Nov Registration fees () for participants covers the following: transport from/to Budapest Ferenc Liszt Airport admission to all scientific sessions conference materials (including programme leaflet, badge, etc.) coffee breaks and lunches social events

3 The registration fee for accompanying persons covers the following: free transport from and to Budapest Ferihegy Airport, lunches and social events. III. Travel details/transfer (Please note that that free transport from and to Budapest is only available between Nov) Do you need transport from and to Budapest airport: Yes No If yes, please provide flight details: Arrival date and time (including flight number and origin): Departure date and time (including flight number and destination): IV. Payment Registration fee Accommodation (beyond the 3 nights) TOTAL Please note that registration will only be confirmed upon full payment! Payments must be made in advance by credit card via Paypal (to or by bank transfer (Account name: EPC2009 Pancreatic Research Foundation, Swift: MKKBHU HB, Account number: HU ). Please indicate the participant s name in the comment!

4 VI. Travel Grants (Please mark with a cross) For ALPD meeting (application is accepted until 30 Sept): Eligability: applicant needs to submit an abstract to the conference and must be under 30 For Young American Delegates (1500 USD covered by NIH) 9 grants are available For Young non-american Delegates (500 Euros, covered by the local organizers) 9 grants are available The travel award recipients will be notified during the first week of October about their award. For meeting (application is accepted until 1 Nov): Eligability: for all members Grant will cover the full registration fee, but NOT accommodation and travel. The travel award recipients will be notified during the first week of November about their award. VII. Special Requirements If you have any special requirements, please provide us further details (food allergies, vegetarian, dietary information, disability, etc.) Please send your registration form via electronically to

5 Funding for this conference was made possible (in part) by Grant R13AA20691 from the National Institute on Alcohol Abuse and Alcoholism (NIAAA). The views expressed in written conference materials or publications and by speakers and moderators do not necessarily reflect the official policies of the Department of Health and Human Services; nor does mention by trade names, commercial practices or organizations imply endorsement by the U.S. Government.

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