• Registration form ISBM 2012

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  •  * Mrs * Mr
  • Title
  • First name *
  • Surname *
  • I took part in the ISBM 2004   2006   2008   2010
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  • My contact details:
  • Institution *
  • Street *
  • No. *
  • Postcode *
  • Town *
  • Country *
  • Telephone *
  • Mobile
  • VAT-No.
  • E-Mail *
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  • Invoice recipient:
  •  as above  as follows
  • Institution *
  • Street *
  • No. *
  • Postcode *
  • Town *
  • Country *
  • VAT-No.
  • E-Mail *
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  • Participant fees Monday to Friday
  •   Participation at a previous ISBM: 5% discountcannot be combined with other discounts
  • Early bird I (ends Dec 31, 2011)€ 1.850,-- plus 20% VAT€ 1.700,-- plus 20% VAT
  • Early bird II (ends Mar 31, 2012)€ 2.050,-- plus 20% VAT€ 1.900,-- plus 20% VAT
  • Participant fees as of 1.4.2012€ 2.250,-- plus 20% VAT€ 2.100,-- plus 20% VAT
  • For registration of three or more participants of the same company we grant 10% discount. (Cannot be combined with other discounts.)
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  • Services included in price:Participation in all the events of the ISBM - Documentation - coffee breaks, daily lunch, dinner Monday-Thursday - Local transport for activities in National Park - Access to the ISBM website's Member Area before and after the event
  • Not included in price:Travel expenses, lodging, breakfast.
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  • Micro-sponsoring
  • I would like to be a micro-sponsor der 5th International Summer School on Business Mediation (For details on our mico-sponsoring offer, please see enclosure)
  • Scholarship for (please give first name and surname):

    Contact details for free participant
    Postal address
    Mail
    Telephone
    Sholarships for
    (please enter number of free places) participants from a non-profit organisation, who cannot finance participation themselves (selection to be made by organizer)
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  • I was made aware of the ISBM 2012 by the following
  • Personal recommendation from
    Mail from the organizer
    Homepage (www.isbm.at)     Folder
    Advert
    Other (which?)
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  • My mediation qualifications
  • Mediation training(s):with:
    Number of training hours:
  • Other qualifications in the areas of conflict, conflict management, mediative competencesPlease specify
  • No mediation training
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  • My mediation experience (multiple rsponses allowed)
  • Experience with use of mediative competences in main job First practical mediation experience
    Carry out mediations regularly
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  • My main profession
  • tax advisor/auditor
    lawyer/notary
    management consultant
    architect/civil engineer     psychotherapist/psychologist
    life coach/counsellor
    Other:
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  • Supplementary programme:
  • Programme for accompanying guests can be booked for an additional charge. Detailed information and registration form can be found here
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  • Expectations of ISBM 2012
  • What is my main interest in Past . Present . Future??
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  • Suggestions to the organizer?
    (topic areas, possible speakers, programme wishes)
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  • * I have read and duly noted the participation conditions (www.isbm.at) and express my agreement hereto.

  • I agree to receive electronic mail for promotional purposes from Konfliktkultur-Kulturkonflikt Patera & Gamm OEG. I may cancel this agreement at any time without stating any reasons.
    yes   no

    You will receive confirmation of registration as well as your invoice via e-mail within 14 days. Your registration is valid once payment is transferred to our account.