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ISR Summer Seminars, Genova, July 23rd – July 25th 2016
REGISTRATION FORM
Please note that the hotel registration has to be done separately.
Family Name: ______________________________________________________________________________________________________________________
First Name: ___________________________________________________________ Title: ________________________________________________________
Address: ___________________________________________________________________________________________________________________________
Zip code/City: _________________________________________________________ Country: _____________________________________________________
E-mail adress or fax no: _______________________________________________________________________________________________________________
__ I am a member of a national Rorschach Society
Name of the Society: _________________________________________________________________________________________________________________
__ I am an individual member of the ISR __ I am a non-member
Please send your registration form to:
Sushila Dixit at Hogrefe AG, Bern, either by e-mail:sushila.dixit@hogrefe.ch or by mail to: Sushila Dixit, Office Manager ISR, c/o Hogrefe AG, Länggass-Strasse 76, CH-3000 Bern 9 (Fax+41313004590).

Registration fee: CHF 495.00 for ISR members; CHF 535.00 for non-members
The registration fee includes: Summer Seminars conference fee, three lunches, water, coffee and coffee breaks in the morning and afternoon.

Registration made before April 30th, 2016 (please make a check mark):
__ Registration fee Summer Seminars CHF 495.00 ISR-member __ CHF 535.00 non-member

Registration after April 30th, 2016:
__ Registration fee Summer Seminars CHF 540.00 ISR-member __ CHF 580.00 non-member

__ I wish to contribute to the ISR grant for students and young professionals*
__CHF 15.00 __CHF 25.00 __CHF 50.00 __CHF 100.00
(*The ISR grant supports students and young professionals with limited financial means who wish to attend ISR activities).
___Evening Event: Social Dinner (60 CHF)
Trattoria in Genova Boccadasse: excellent fish restaurant in one of the oldest neighbourhoods of Genova
__ Total (CHF __________)
The registration fee (and contribution) is payable by means of
__ EUROCARD/MasterCard or __ VISA
Card Number:________________________________ Expiration Date:___________________________________

__ Transfer to the bank account of the International Society of the Rorschach with CREDIT SUISSE, 3001 Bern, account no.395980-00-1.IBAN CH5004835039598000001/BIC: CRESCHZZ30R.
Cancellations up to 2 months before the program will qualify for a 50% refund. Upto1 month before = 25%. Thereafter no refund will be made.
Registrations are accepted and confirmed in order of receipt and are limited in number.