Baltic Osseointegration Academy

Event
First Name
Last name
Sex	Male Female
Institution
Mailing address
Zip/Area code
City
Country
Phone no.
Fax
e-mail

Price (Registration fee after 10-08-2010 will be changed.)

Payment grand total

Method of Payment

We offer 2 methods of payment.

1. You can transfer the fee to the BOA bank account:

Recipient - Baltijos osteointegracijos akademija

Address of recipient: Vytauto pr. 85-3, LT-44238 Kaunas, Lithuania

Company's code: 191796017

Bank: AB SEB bank

Address of the bank: Gedimino pr. 12, LT-01103 Vilnius, Lithuania

Bank code: 70440

SWIFT: CBVI LT 2X, IBAN No.LT56 7044 0600 0107 5499

Account no. LT56 7044 0600 0107 5499

2. We can charge money from your Credit card:

Mastercard Visa

Card Holder (first name, second name):

Credit card number (no spacing):

Expire date:

C.V.V. (the last 4 digits of the number in the back side of your card, in the signature panel):

By pressing the submit button I accept the cancellation terms.

Cancellation Policy

All cancellations must be notified in writing (by mail or fax) to the Congress Office according
to the following conditions:

- Before August 10th: total amount will be refunded except 10 Eur for administrative fees.
With no payment received before cancellation, these 10 Eur will still remain due.

- Between August 10th and August 25th: Reimbursement of 50% of the fee. With no payment
received before cancellation, this amount will still remain due.

- After September 1st: No refund. With no payment received before that date, the total amount
will still remain due to the Congress office.

Become member

Registration form