Payment method

Payment by invoice or EAN number:
Be aware of an administration fee of DKK 100,-
EAN number:*
Payment address:*
Contact person:**
CVR number

General information

Name:*
Telephone:*
Institution:*
Department:*
Telephone (Department):*
Invoice e-mail:*
You will receive the invoice on this e-mail address
Invoice address:*
Country:*
E-mail:*
A confirmation mail will be sent to this e-mail address

Participant







Other information

I will submit an abstract:* Yes
No
I intend to participate in the dinner Monday
Tuesday
*Deadline for registration and submission of abstract: 12 October 2018

Payment terms

You will within a few weeks receive an invoice from Lundbeckfonden. Net sum upon receipt of invoice to:

Reg. no.: 3100
Account no.: 3120 108 565

Outside of Denmark, please use:
SWIFT : DABADKKK
IBAN: DK75 3000 3120 1085 65.

Please make sure that your payment has been processed.
If we haven't received your payment before 10 November 2018, your registration will be cancelled.

IMPORTANT! Please make reference to: 'The Brain Prize Meeting' and provide your name when making the payment.

Scherfigsvej 7
2100 Copenhagen Ø
Denmark
Tel. +45 39 12 80 00
CVR-nr. 11 81 49 13
thebrainprize@lundbeckfonden.com
www.thebrainprize.org
Nils Axelsen Ralf Hemmingsen Lauritz Holm-Nielsen Ralf Hemmingsen Jens Oddershede Jens Frederik Rehfeld Anders Bjørklund