Application to be completed carefully by each participant
1. Family name :
2. First name :
3. Birth date :
4. Profession/Occupation :
5. Work place and its address :
6. Corresponding address, including e-mail :
7. Phone numbers :
8. I am a member of the Romanian Apitherapy Society: Yes /No
9. I am a member of the International Federation of Apitherapy: Yes /No
10. I paid the membership fees for 2014 for the membership in the Romanian Apitherapy Society (25 Eur for individual members; 50 Eur for firms/companies): Yes / No.
11. I paid the membership fees for 2014 for the membership in the International Federation of Apitherapy (50 Eur for individual members; 100 Eur for firms/companies; 150 Eur for associations): Yes / No.
12. I paid the Congress participant fees : Yes / No
– 30 Eur for Romanian Apitherapy Society’s or International Federation of Apitherapy’s members;
– 60 Eur for non-members.
– 20 Euro/person for my family accompanying members (relatives of first degree)
Please mention here the complete name of the person(s) that is (are) accompanying you : …………………………
13. I paid my seat for the Festive dinner and night bar with artistic program (Saturday evening, October 18-th.), in Hotel Aro-Palace (25 euro/person): Yes / No
14. I will participate to the post-Congress Tours : Yes / No. If Yes , please mention to which of them .
15. I paid my participation to the post-Congress Tour from Sunday, October 19-th. to Rasnov Citadel and Bran Castle (30 Euro/person) : Yes / No
16. I paid my participation to the post-Congress intensive Workshops (October 20 and 21) : Yes / No
– only 60 Eur for the International Federation of Apitherapy or Romanian Apitherapy Society’s members;
– 120 Eur for the non-members.
– only 30 Euro for the accompanying members
17. Please mention here the technical details of your payment: wire transfer number …… / date ………….. / name of the person/institution paying your Congress/Apiexpo/Workshop/Tours fees: …………………………..
for (name of participant):……………………………… in R.A.S. bank account.
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To be able to register faster your aplication form and thus ensure your place to our event, please send us, as urgent as possible, this application form andthe scanned copy of your payment to : secretariat@apiterapie.ro + crispavel@yahoo.com + drstangaciu@gmail.com