The 12th Colloquium on Baltic Sea Marine Geology September 8 – 12, 2014
Payment by Credit Card
Please complete the form and fax it to the Baltic 2014 Organization Committee +49 (381) 5197 352 Name: ___________________________________________________
Company/Org.: ____________________________________________
Address: _________________________________________________
Country: _________________________________________________
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By signing this form, I authorize the Baltic 2014 organization committee at the Leibniz-Institute for Baltic Sea Research in Warnemünde to charge my credit card for the amount of
Registration fee:
(please tick the appropriate box)❑ 120€ - Reduced fee (PhD students only – please include proof of PhD status)
❑ 220€ - Regular fee
Extra fee:
(please tick if desired)❑ 25€ - Excursion to Rugen Island (Sept. 12th, 2014)
The fee includes the costs of the participation in the icebreaker party and the conference dinner. It is not possible to make any reductions on the fee if you are not attending these events.
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Please complete the form and fax it to the Baltic 2014 Organization Committee +49 (381) 5197 352
