Registration Form

                               Ultrasound  Course                           Regensburg , Germany   June 5 - 7, 2008
                 Ultrasound    Workshop                        Regensburg , Germany   June 9, 2008          

  Please complete and fax or e-mail to:   Karl C. Ossoinig, MD  ( University of Iowa )
E-Mail:    kcossoinig@mchsi.com                           FAX:  011 - 319 - 338 0377

NAME: ______________________________________     TITLE:__________________________

ADDRESS: ___________________________________    TELEPHONE:____________________

CITY: ________________________________________    Postal Code: ____________________

COUNTRY: _____________________________        FAX: ___________________________

E-MAIL ADDRESS: ________________________________________

  Please  √  appropriate boxes:

The Course (and Workshop) Fees in the amount of  EURO____________   was (were) remitted by Bank Transfer

                                        will be paid in cash or Euroscheck at Course Registration

 Additional Workshop Participation   

for the                  FOR THE APPROPRIATE COURSE and  WORKSHOP FEES and how to pay for PRE-REGISTRATION see under "COURSE ENROLLMENT"