Activity name

Participant fee (early registration): *** Euros

Payment can be made via credit card or bank transfer, please complete the form below.

    Registrant Details

    Are you the person taking part in this activity?

    Please provide your details:

    Do you require an invoice from FENS?

    Options

    Option 1

    Option 2

    How would you like to pay?

    Please note that a €25 handling fee will be added to the total registration fee. IMPORTANT: All bank charges, including transfer fees, must be paid by the sender, in addition to the payable fee.

    Please send your payment, free of charge for the beneficiary, to the bank account below (NOTE: this information will also be emailed to you after submission of this form):

    Account holder: Stichting Federation of European Neuroscience Societies

    Bank: BNP Paribas Fortis SA, Square du Bastion 9, 1050 Brussels, Belgium

    Account Address: Rue d’Egmont 11, 1000 Brussels, Belgium

    IBAN: BE97 0017 7341 7149

    BIC: GEBABEBB

    Please indicate the complete first name and last name of the registered person in addition to the name of the activity in the transfer communication.

    Your registration will be considered valid only upon receipt of your payment.

    Please send a copy of your registration confirmation together with the bank transfer receipt by email to the registration secretariat - office@fens.org