To the

International Center for Advanced Studies

in Health Sciences and Services (ICAS)
of the Faculty of Medicine
of the University of Ulm
in cooperation with the Academy for Science, Industry
and Technology at the University of Ulm
Prof. Dr. T.M. Fliedner
Helmholtzstr. 20
D-89081 Ulm
Fax: ++49-731-500-69406
e-mail: theodor.fliedner@uni-ulm.de


REGI STRATI ON

Advanced ICAS Training Course on
Blood Stem Cell Transplantation: State-of-the-Arts, Methods and
Perspectives, April 16-19, 2007

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Phone Fax E-Mail

Fee (taxes included):
- for registration before February 5, 2007 750,-- !
- for registration after February 5, 2007 850,-- !

The participant obliges himself to settle the registration fee upon confirmation of his application and
receipt of the invoice without discounts during the given credit period. Resignation is possible till two
weeks before the start of the course program, the participation fee is refunded less 10% handling
charge. After this date no more repayment is possible. A substitute participant can be named at any
time. As for the rest the general terms and conditions of the academy are valid. We will send them to
you on request.

Place, date stamp and signature