Participant

* Surname 

* First name 

Title 

Gender 

 Male      Female

* Organisation 

* Postal Address 

* City 

* Post/Zip Code 

* Country 

* Email 

Telephone 

Fax 

I would like to present a poster.   Yes

If yes, title of the poster

My name and contact details may be printed 
and distributed in the participants list 

 Yes      No

Registration fees *
Please select your registration preference

3 day registration

  350.- Euro

3 day registration (reduced fee)

  175.- Euro

3 day registration (students)

  175.- Euro

Country and income: Please select your country ... Afghanistan, AFG, Low income Albania, ALB, Lower middle income Algeria, DZA, Lower middle income American Samoa, ASM, Upper middle income Andorra, ADO, High income Angola, AGO, Low income Antigua and Barbuda, ATG, Upper middle income Argentina, ARG, Upper middle income Armenia, ARM, Low income Aruba, ABW, High income Australia, AUS, High income Austria, AUT, High income Azerbaijan, AZE, Low income Bahamas, The, BHS, High income Bahrain, BHR, High income Bangladesh, BGD, Low income Barbados, BRB, Upper middle income Belarus, BLR, Lower middle income Belgium, BEL, High income Belize, BLZ, Lower middle income Benin, BEN, Low income Bermuda, BMU, High income Bhutan, BTN, Low income Bolivia, BOL, Lower middle income Bosnia and Herzegovina, BIH, Lower middle income Botswana, BWA, Upper middle income Brazil, BRA, Upper middle income Brunei, BRN, High income Bulgaria, BGR, Lower middle income Burkina Faso, BFA, Low income Burundi, BDI, Low income Cambodia, KHM, Low income Cameroon, CMR, Low income Canada, CAN, High income Cape Verde, CPV, Lower middle income Cayman Islands, CYM, High income Central African Republic, CAF, Low income Chad, TCD, Low income Channel Islands, CHI, High income Chile, CHL, Upper middle income China, CHN, Lower middle income Colombia, COL, Lower middle income Comoros, COM, Low income Congo, Dem. Rep., ZAR, Low income Congo, Rep., COG, Low income Costa Rica, CRI, Upper middle income Croatia, HRV, Upper middle income Cuba, CUB, Lower middle income Cyprus, CYP, High income Czech Republic, CZE, Upper middle income Côte d'Ivoire, CIV, Low income Denmark, DNK, High income Djibouti, DJI, Lower middle income Dominica, DMA, Upper middle income Dominican Republic, DOM, Lower middle income East Timor, TMP, Low income Ecuador, ECU, Lower middle income Egypt, Arab Rep., EGY, Lower middle income El Salvador, SLV, Lower middle income Equatorial Guinea, GNQ, Low income Eritrea, ERI, Low income Estonia, EST, Upper middle income Ethiopia, ETH, Low income Faeroe Islands, FRO, High income Fiji, FJI, Lower middle income Finland, FIN, High income France, FRA, High income French Polynesia, PYF, High income Gabon, GAB, Upper middle income Gambia, The, GMB, Low income Georgia, GEO, Low income Germany, DEU, High income Ghana, GHA, Low income Greece, GRC, High income Greenland, GRL, High income Grenada, GRD, Upper middle income Guam, GUM, High income Guatemala, GTM, Lower middle income Guinea, GIN, Low income Guinea-Bissau, GNB, Low income Guyana, GUY, Lower middle income Haiti, HTI, Low income Honduras, HND, Lower middle income Hong Kong, China, HKG, High income Hungary, HUN, Upper middle income Iceland, ISL, High income India, IND, Low income Indonesia, IDN, Low income Iran, Islamic Rep., IRN, Lower middle income Iraq, IRQ, Lower middle income Ireland, IRL, High income Isle of Man, IMY, Upper middle income Israel, ISR, High income Italy, ITA, High income Jamaica, JAM, Lower middle income Japan, JPN, High income Jordan, JOR, Lower middle income Kazakhstan, KAZ, Lower middle income Kenya, KEN, Low income Kiribati, KIR, Lower middle income Korea, Dem. Rep., PRK, Low income Korea, Rep., KOR, High income Kuwait, KWT, High income Kyrgyz Republic, KGZ, Low income Lao PDR, LAO, Low income Latvia, LVA, Upper middle income Lebanon, LBN, Upper middle income Lesotho, LSO, Low income Liberia, LBR, Low income Libya, LBY, Upper middle income Liechtenstein, LIE, High income Lithuania, LTU, Upper middle income Luxembourg, LUX, High income Macao, China, MAC, High income Macedonia, FYR, MKD, Lower middle income Madagascar, MDG, Low income Malawi, MWI, Low income Malaysia, MYS, Upper middle income Maldives, MDV, Lower middle income Mali, MLI, Low income Malta, MLT, Upper middle income Marshall Islands, MHL, Lower middle income Mauritania, MRT, Low income Mauritius, MUS, Upper middle income Mayotte, MYT, Upper middle income Mexico, MEX, Upper middle income Micronesia, Fed. Sts., FSM, Lower middle income Moldova, MDA, Low income Monaco, MCO, High income Mongolia, MNG, Low income Morocco, MAR, Lower middle income Mozambique, MOZ, Low income Myanmar, MMR, Low income Namibia, NAM, Lower middle income Nepal, NPL, Low income Netherlands, NLD, High income Netherlands Antilles, ANT, High income New Caledonia, NCL, High income New Zealand, NZL, High income Nicaragua, NIC, Low income Niger, NER, Low income Nigeria, NGA, Low income Northern Mariana Islands, MNP, High income Norway, NOR, High income Oman, OMN, Upper middle income Pakistan, PAK, Low income Palau, PLW, Upper middle income Panama, PAN, Upper middle income Papua New Guinea, PNG, Low income Paraguay, PRY, Lower middle income Peru, PER, Lower middle income Philippines, PHL, Lower middle income Poland, POL, Upper middle income Portugal, PRT, High income Puerto Rico, PRI, Upper middle income Qatar, QAT, High income Romania, ROM, Lower middle income Russian Federation, RUS, Lower middle income Rwanda, RWA, Low income Samoa, WSM, Lower middle income San Marino, SMR, High income Saudi Arabia, SAU, Upper middle income Senegal, SEN, Low income Seychelles, SYC, Upper middle income Sierra Leone, SLE, Low income Singapore, SGP, High income Slovak Republic, SVK, Upper middle income Slovenia, SVN, High income Solomon Islands, SLB, Low income Somalia, SOM, Low income South Africa, ZAF, Lower middle income Spain, ESP, High income Sri Lanka, LKA, Lower middle income St. Kitts and Nevis, KNA, Upper middle income St. Lucia, LCA, Upper middle income St. Vincent and the Grenadines, VCT, Lower middle income Sudan, SDN, Low income Suriname, SUR, Lower middle income Swaziland, SWZ, Lower middle income Sweden, SWE, High income Switzerland, CHE, High income Syrian Arab Republic, SYR, Lower middle income São Tomé and Principe, STP, Low income Tajikistan, TJK, Low income Tanzania, TZA, Low income Thailand, THA, Lower middle income Togo, TGO, Low income Tonga, TON, Lower middle income Trinidad and Tobago, TTO, Upper middle income Tunisia, TUN, Lower middle income Turkey, TUR, Lower middle income Turkmenistan, TKM, Lower middle income Uganda, UGA, Low income Ukraine, UKR, Low income United Arab Emirates, ARE, High income United Kingdom, GBR, High income United States, USA, High income Uruguay, URY, Upper middle income Uzbekistan, UZB, Low income Vanuatu, VUT, Lower middle income Venezuela, RB, VEN, Upper middle income Vietnam, VNM, Low income Virgin Islands (U.S.), VIR, High income West Bank and Gaza, WBG, Lower middle income Yemen, Rep., YEM, Low income Yugoslavia, Fed. Rep., YUG, Lower middle income Zambia, ZMB, Low income Zimbabwe, ZWE, Low income

Indicate method of payment *

Please send your cheque or bank draft to address stated below,
or by using our Easy Credit Card Payment System.

Federal Environmental Agency
Attn. Mr Michael Frobel
- 0111/water-safety -
PO Box 330022
D - 14191 Berlin, Germany

I will send a cheque / bank draft made out to
"Bundeskasse Berlin 0111/water-safety".

Credit card payment

For your information: On your credit card account the conference fee will be indicated as "Werbung und Vertrieb".

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