I would like to register the following number of participants as follows:

Early-bird registration (by 12 May 2016):

0123456789 x Member rate (€375)

0123456789 x Non-Member rate (€435)

0123456789 x Partner rate (€90)

Standard registration (after 12 May 2016):

0123456789 x Member rate (€425)

0123456789 x Non-Member rate (€485)

0123456789 x Partner rate (€140)

Optional Dinner (at own cost) - Saturday evening for those staying on

0123456789 x I/we would like to join the group for dinner on the Saturday evening

0123456789 x I am/we are travelling home or have other arrangements on the Saturday

Hotel Accommodation

Hotel accommodation is not included in the workshop fee.

If you wish to stay at the congress venue (Dietrich Bonhoeffer Haus, a 3 star hotel), where all the sessions will be held, you can reserve accommodation below and make payment direct to the hotel on departure.

Other hotels within walking distance of the congress venue (Dietrich Bonhoeffer Haus hotel) are:

Meliá Berlin Friedrichstrasse (4 star hotel)

NH Collection Berlin Friedrichstrasse (4 star hotel)

You can also use online hotel search services such as www.booking.com and www.hrs.com to find a hotel of your choice in Berlin.

I will book my own hotel accommodation

Please reserve a room/s for me at the Dietrich Bonhoeffer Haus hotel

Date of arrival

Date of departure

A limited number of rooms have been reserved for arrival on 10 June and departure on 11 or 12 June. Please book early to avoid disappointment! If you wish to stay longer we will put in a request to the hotel, but we cannot guarantee that a room will be available for arrival before 10 June or departure after 12 June!

0123456789 x EUR 89,00 – single bed, single occupancy, including full buffet breakfast

0123456789 x EUR 130,00 – double bed, double occupancy, including full buffet breakfast

Special Requirements

Please provide the following number of participants with vegetarian meals:

0123456789 x Vegetarian (including fish)

0123456789 x Vegetarian (not including fish)

I have the following request/special requirement:

Name of Participant:

Email of Participant:

Mobile phone number of Participant:

Name of Partner (not attending conference):

Company:

Address (only required for non-members, include zip and city):

Country:

* Name:

* Email:

[ A copy of this form will be sent to you by e-mail. ]