International Workshop Allergen Vaccines and Vaccines Adyuvants

Central Park Hotel, Havana, Cuba, May 28 to June 2, 2015

Registration Form

• Participant:  MD: __ Prof.___  PhD :___   Accompanying Person:___
• Sector:  Private Sector :   Academic and Governmental Sectors:    Student:
• Gender:  Female:  ___    Male: ____
• First name:  ___________________________  Last name: ______________
• Passport Number:_____________________     Job Title: ____________
• Organization/Company: _________________________________________
• Department: ___________________________________________________
• Address: ______________________________________________________
• City: ___________________________
• Postal code: _____________________             Country: ______________
• Fax: ___________________________             e-mail: ________________
• Title of my presentation: __________________________________________
• Presentation type preference: Oral: ___   Poster: ______  NO presentation:__
• My organisation is interested in sponsoring International Workshop Allergen
• Vaccines and Vaccines adyuvants 2015

Yes___  No ___

• Please send me details of commercial exhibition: ___

*Price in Euros

Note: The registration payment should not be done in USD and should be done through the meeting account:

Name: Sociedad Cubana de Inmunología
Account number: 0524120042720328
Bank Name: BANCO Metropolitano S.A, 241
Branch address: 5th ave. and 84, Playa, Havana, Cuba
Bank identification code (Switch code):
IBAN (International Bank Account Number): There is not IBAN for Cuban Banks

Please send the payment writing your full name and your registration to the e-mail: allergen2015@finlay.edu.cu