Scand J Psycho1 33 (1992) Announcement 19 1
THE FIFTH NORDIC MEETING O N BEHAVIOUR THERAPY REYKJAVIK ICELAND, APRIL 23-25, 1992
CONGRESS REGISTRATION FORM
Must be received no later than February 15, 1992
PARTICIPANT:
Name: ............................................................................................................................................................ Title: .....................
Address: ......................................................... .............................................................................................................................
............................................................................ country: .... ......................
Phone: ............................................................................................... Fax: ...................................................................................
Accompanying person(s): .............. .............................................................................................................................
.....................................................................................................................................................................................................................
A. CONGRESS REGISTRATION FEE
Member of a Nordic Behaviour Therapy Association SEK 1280 0 Non-Member . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . SEK 1390 0
. . . . .
B. PRE-CONGRESS REGISTRATION FEE
Member of a Nordic Behaviour Therapy Association SEK 920 0 Non-Member . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . SEK 980 0
. . . . .
My first choice is workshop ao. ..................... My second choice is workshop no. ................... My third choice is workshop no. .....................
C. CONGRESS AND PRE- CONGRESS REGISTRATION FEE
Member of a Nordic Behaviour Therapy Association SEK 1990 Non-Member . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . SEK 2200 0
. . . . .
D. CONGRESSBANQUET . . . . . . . . . . . . . . . . . . . . . . SEK 390 0
PAYMENT
TOTAL SUM A + B or C + D . . . . . . . . . . . . . . . . . . SEK ...............
1. Send a cheque payable to the Icelandic Behaviour Association on our office's address: The University of Iceland, Institution for Continuing Education, Dunhaga 5, 107 REYKJAVIK, Iceland.
2. Pay to our account No. 0532-38-560007 at Islandsbanki. 3. We credit your VISA account No. ........................................................ (16 digits).
We credit your EUROCARD account No. ........................................................ (16 digits). Card expires end of ..................................
.............................................................................................................................................................................................. Dmtc and p l r c Sgnuurc of credit urd holder
