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www.complications-in-endoscopy.com
P R O G R A M M E
3. International Symposium on
Complications in GI-Endoscopy
This course is endorsed by theAmerican Society for GastrointestinalEndoscopy
Certified and CME credits bythe EBGH
Under the patronage
of the ESGE
28-29J u n e2 0 1 3
Under the patronage of theGerman Society forGastroenterology
28-29 June 2013Maritim Airport Hotel Hannover, Germany
Honorary President
Meinhard Classen, Munich
Course Director
Peter N Meier, Hannover
Scientific Committee
Lars Aabakken, OsloIan Gralnek, HaifaRob Hawes, OrlandoHelmut Messmann, AugsburgChrista Meyenberger, St. GallenThierry Ponchon, LyonKrish Ragunath, NottinghamNageshwar Reddy, Hyderabad
State of the Art Lecture
Christopher Williams, London
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Course Director
Dr. Peter N. Meier, FASGEDirector of the Department of Internal Medicine IIGastroenterology, Endoscopy, Metabolic DiseasesDiakoniekrankenhaus Henriettenstiftung gGmbHSchwemannstr. 1730559 HannoverGermany
www.complications-in-endoscopy.com
Contents
Let’s talk about it – again! 4
Programme Friday, 28 June 2013 6
Working groups, congress dinner 7
Programme Saturday, 29 June 2013 8
Poster session, call for abstracts 10
Registration, evening programme, 12meeting venue, accommodation, congress language, travel information,contact
Faculty 14
28-29J u n e2 0 1 3
3. International Symposium on
Complications in GI Endoscopy
4
3. International Symposium on Complications in GI Endoscopy
Pre
face Dear friends and colleagues,
Being committed endoscopists, we are all concerned that even minorinvasive procedures may have side effects which might result in a so-called complication. The constant evolution, not only of imaging but also of invasive or surgical concepts, requires a permanent process of reflection.
As in previous years, the aims of the symposium are to
identify critical incidents and complications
communicate unforeseen events
develop strategies to avoid or minimise complications
demonstrate therapeutical measures for the eventuality of a complication
which we will discuss under technical, procedural, ethical, psychologicaland legal aspects.
A highlight of our symposium will be the state-of-the-art lecture by Prof. Christopher Williams. Christopher Williams is not only a globally reputed developer of endoscopic techniques but also the grandseigneur of colonoscopy.
We are honoured that Christopher Williams accepted ourinvitation and allows us to share his lifelong experiencesduring his lecture on quality and safety in colonoscopy.
Let's talk about it –again!
5
28-29 June 2013
Preface
Honorary president of the 3. International Symposium onComplications in GI Endoscopy is Prof. Dr. Drs. h.c.Meinhard Classen.
Meinhard Classen’s importance for modern endoscopy islegendary, he influenced therapeutic endoscopy like no oneelse, for example, via the introduction of ERCP and EPT. Hereceived prizes for his scientific work all over the world, andwe are proud that he accepted to be honorary president ofthis symposium.
Very special thanks go to the members of the ScientificCommittee who put a lot of personal engagement in helping to select
topics and renowned speakers to make thissymposium a useful tool for every endoscopistin his every-day clinical work.
The Scientific Committee and I invite you tocome to Hannover on 28 and 29 June 2013,listen to the experts’ lectures and share yourexperiences with the other participants in ourworking groups. We especially encourage youand your co-workers to send in relevantabstracts. Selected abstracts will be presentedas lectures in the main programme, all otherswill be presented in the poster exhibition.
Looking forward to meeting you in June 2013!
Scientific Committee
Lars Aabakken, Oslo
Ian Gralnek, Haifa
Rob Hawes, Orlando
Helmut Messmann, Augsburg
Christa Meyenberger, St. Gallen
Thierry Ponchon, Lyon
Krish Ragunath, Nottingham
Nageshwar Reddy, Hyderabad
Peter N. Meier, FASGE
6
3. International Symposium on Complications in GI Endoscopy
Programme Friday, 28 June 201310:00 – 10:30 Welcome coffee in the foyer
10:30 Welcome P. MeierM. Classen
10:40 Welcome address of the President elect J. Jähneof the German Society for Surgery
10:45 – 12:45 Session 1: Basics and communication
Chair: J. Jähne, A. Meining, T. Ponchon
10:45 Quality measurements to prevent K. Mergener complications
11:05 Responsibility and personality: K. Ragunathhuman factors
11:25 Can over- and undertreatment J. Weberresult in complications?
11:45 Behaviour and guilt: How to behave J. Beercorrectly in case of a complication
12:05 My worst case H. Neumann
12:15 Discussion
12:45 – 13:45 Lunch buffet
13:45 – 15:45 Session 2: Technology and general conditions
Chair: M. Dinis-Ribeiro, H. Feußner, H. Messmann
13:45 My worst case J. Pohl
13:55 Stenting: from blessing to curse P. Siersema
14:15 Endoscopy in patients with advanced T. Seufferleintumor diseases: Hazard or benefit?
14:35 Electrosurgery: Dangers and pitfalls G. Csomós
14:55 Endoscopic repair of mucosal defects G. Kähler
15:15 Selected poster abstract to be announced
15:25 Discussion
15:45 – 16:30 Coffee break
Pro
gram
me
28-29 June 2013
16:30 – 18:00 Session 3: Working groups
On Friday afternoon, we offer working groups for intensified discussion ofcomplications arising in some main endoscopic procedures. In addition,we offer a working group for endoscopy nurses in German language.Together with the experts you will work out the status quo, typical andcommon complications and possible ways of minimising or preventingcomplications. A summary of the results of each working group will bereported to the plenum on Saturday morning.
The working groups take place in parallel sessions, so please enroll forone topic only with your registration:
Congress dinner on Friday, 28 June 2013
18:45 Bus transfer to the Town Hall
19:15 Reception by the Lord Mayor of Hannover
20:00 Dinner at the Town Hall Garden Restaurant
Please enroll for dinner with your registration as seats are limited!
1. EMR/ESD/NOTESChair: J. Hochberger, K. Lehmann, N. Reddy
2. ColonoscopyChair: H. Messmann, G. Rotondano, F. Schreiber
3. ERCP Chair: L. Aabakken, H.-D. Allescher, R. Hawes
4. Instruments and accessoriesChair: H. Feußner, T. Ortmaier, R. Tamm
5. EUSChair: M. Barthet, C. Meyenberger, H. Neye
6. Endoskopie = Arbeit im TeamArbeitsgruppe für Endo sko pie - assistenzVorsitz: M. Engelke, H.-J. Schulz
Program
me
7
8
3. International Symposium on Complications in GI Endoscopy
Programme Saturday, 29 June 201308:30 – 10:00 Session 4: Reports of the working groups
Chair: E. Fedorov, M. Jung, G. Kähler
08:30 Endoskopie = Arbeit im Team M. Engelke H.-J. Schulz
08:45 EUS M. Barthet C. MeyenbergerH. Neye
09:00 Instruments and accessories H. Feußner T. Ortmaier R. Tamm
09:15 ERCP L. Aabakken H.-D. AllescherR. Hawes
09:30 Colonoscopy H. Messmann G. Rotondano F. Schreiber
09:45 EMR/ESD/NOTES J. Hochberger K. Lehmann N. Reddy
10:00 – 10:20 Coffee break
10:20 – 11:45 Session 5: Focus on hepato-bilio-pancreatic procedures
Chair: C. Germer, S. Meisner, H. Messmann
10:20 Selected poster abstract To be announced
10:30 Complications in endoscopic drainage M. Barthetof pancreatic fluid collections
10:50 Access to the bilio-pancreatic system: L. AabakkenWhat is the right algorithm to minimise complications?
11:10 Access to the pancreas: How to pass the T. Ponchonpapilla without causing collateral damage
Pro
gram
me
9
28-29 June 2013
11.30 Selected poster abstract To be announced
11:40 Discussion
11:45 – 12:00 Coffee break
12:00 – 13:45 Session 6: Standards and Future
Chair: H. Buhr, M. Classen, N. Reddy
12:00 Iatrogene induced haemorrhage I. Gralnek
12:20 Development of new technologies for R. Hawesthe prevention of complications
12:40 Thinking out of the box: When medicine I. Wunnand religion collide
State-of-the-art lecture
13:00 Introduction M. Classen
13:10 Quality and safety in colonoscopy C. Williams
13:40 Farewell P. Meier
13:45 – 14:30 Farewell lunch buffet
Program
me
Poster Committee: I. Jovanovic, T. Wehrmann
Posters will be exhibited on 28 and 29 June 2013 at the Maritim AirportHotel Hannover.
The authors will be in attendance during the coffee break on Friday after-noon while the Poster Committee will evaluate the posters.
Call for abstracts
Please submit your poster abstract by 15 April 2013. Only one-pageabstracts not exceeding 250 words, written in English and saved inMicrosoft Word format will be accepted.
Abstracts must be submitted via our Internet Abstract Submission System (http://www.falkfoundation.com/poster) where further information regard -ing the submission format and the submission process is available.Please visit our congress website www.complications-in-endoscopy.comfor a link to the Falk Foundation abstract submission.
The abstracts will undergo a review by the Scientific Committee, prefe-rence being given to those thematically related to one of the sessions ofthe programme. We especially encourage submissions of cases. Haveyou, for example:
come across a very rare or unusual complication?
developed a special technique to deal with specific complications?
experienced a disaster?
Then we invite you to send us your abstract!
10
3. International Symposium on Complications in GI Endoscopy
Poster session, call for abstracts
Pos
ter
Ses
sion
11
28-29 June 2013
Poster S
ession
&
All accepted abstracts will be printed and distributed to the participantsof the congress together with the documents of the meeting. The authorswill receive notification about acceptance and further instructions by 10 May 2013.
The first author of any accepted poster is invited to take part in the sym-posium free of registration fee. Please note: Travel expenses are notcovered.
Contact address for questions concerning the poster submission:
Falk Foundation e.V.Leinenweberstr. 579041 Freiburg, GermanyTelephone: +49 (0)761 / 15 14-0Telefax: +49 (0)761 / 15 14-359Web address for submitting poster abstracts:http://www.falkfoundation.com/poster
Poster prizes
For the presenting authors of those three abstracts selected by theScientific Committee for oral presentation, registration fee, accommo -dation and travel expenses will be covered.
The three best posters, selected by the Poster Committee during theposter session, will win a prize certificate and an award of 750,- €.
Deadline for submission of abstracts: 15 April 2013
12
3. International Symposium on Complications in GI Endoscopy
Reg
istr
atio
n
Please visit our congress website www.complications-in-endoscopy.com forregistration, hotel booking and further information.
Registration fee
The registration fee includes access to the lecture hall, choice of one workinggroup, coffee breaks with snacks, rich lunch buffets with a selection of warm andcold dishes on Friday and Saturday, certificate of participation and the get-togetheron Thursday.
Physicians: until 15 April 2013 160,- €
from 16 April 2013 220,- €ESGE Individual Members receive a 20% reduction on the registration fee
Nurses and students: until 15 April 2013 40,- €
from 16 April 2013 70,- €
Team (1 physician, until 15 April 2013 190,- €
up to 2 nurses): from 16 April 2013 250,- €
You may either register online on www.complications-in-endoscopy.com or fill inthe enclosed registration form.
Get-together on Thursday, 27 June 2013
Participants arriving already on Thursday are invited to a get-together at theMaritim Airport Hotel with drinks and light warm and cold dishes, starting 7 pm.The get-together is included in the registration fee.
Congress dinner on Friday, 28 June 2013
The fee includes bus transport from the meeting venue to the restaurant and back,reception and dinner at the beautiful Town Hall Garden Restaurant.
Participant: 30,- €
Accompanying Person : 45,- €
Registration, evening programme
13
28-29 June 2013
Meeting venue – Maritim Airport Hotel
The symposium takes place at the Maritim Airport Hotel in Hannover, Germany.This magnificent hotel will delight you with its comfort and ideal location on the air-port grounds.
Arrival by plane: The hotel is just a 2-minute footwalk away from the Arrival Hall.
Arrival by car: Take the exit to the airport from highways A2 and A7.
Arrival by train: From Hannover main station, the local tram S5 to “HannoverFlughafen” takes you to the airport and hotel in 18 min.
A taxi from Hannover main station to the airport takes around 20 min. and costsaround 25,- €.
Hotel accommodation
We have reserved a number of rooms at a special congress rate. You may bookyour room either online on our congress website or with the registration form included in this brochure.
Single room including breakfast: 119,- €
Double / twin room including breakfast: 158,- €
Room rates include all service charges and VAT.
Congress language
The congress language is English except for the working group for nurses which isin German.
Die Arbeitsgruppe für Endoskopieassistenz „Patientensicherheit in der Endoskopie”findet in deutscher Sprache statt.
Contact
For any further questions concerning registration and hotel booking, please contact:
COCS GmbH – Congress Organisation C. SchaeferRosenheimer Str. 145c81671 Munich, GermanyPhone: +49 (0)89 / 89 06 77-0 Fax: +49 (0)89 / 89 06 77-77Email: [email protected]
Meeting venue, accommodation, congress language, travel information, contact
Meeting venue
Aabakken, Lars, MD PhDProfessor, Chief of Endoscopy Dept. of Medical Gastroenterology Rikshospitalet University Hospital 0027 Oslo, Norway
Allescher, Hans-Dieter, Prof. Dr.Zentrum Innere MedizinGastroenterologie, Hepatologieund Stoffwechsel, KlinikumGarmisch-PartenkirchenAuenstraße 6, 82467 Garmisch-Partenkirchen, Germany
Barthet, Marc, Prof. Dr.Service d'hépato-gastro -entérologie, Hôpital Nord Chemin des Bourrely 13915 Marseille cedex 20, France
Beer, JohnBeer advocatenWeteringschans 85-871017 RZ Amsterdam, Netherlands
Buhr, Heinz, Prof. Dr.Klinik für Allgemein-, Gefäß- undThoraxchirurgie, Charité – CampusBenjamin FranklinHindenburgdamm 3012200 Berlin, Germany
Classen, Meinhard, Prof. Dr. Drs.h.c., Em. Direktor II.Med. KlinikKlinikum rechts der IsarTechnische Universität München Ismaninger Straße 2281675 München, Germany
Csomós, Guido, Dr.Helios Hanseklinikum StralsundMedizinische KlinikGroße Parower Straße 47-5318435 Stralsund, Germany
Dinis-Ribeiro, Mario, MD PhDServico de GastrenterologiaInstituto Portugues de Oncologia'Francisco Gentil'Rua Dr Antonio Bernardino deAlmeida4200-072 Porto, Portugal
Engelke, MonikaBildungszentrum RuhrHospitalstraße 1944649 Herne, Germany
Fedorov, Evgeny D., Prof. Dr. University Hospital No. 31Russia State Medical UniversityDept. of Digestive Endoscopy Lobachevskogo Str. 42 119415 Moscow, Russia
Feußner, Hubertus, Prof. Dr.Chirurgische Klinik und PoliklinikKlinikum rechts der IsarTechnische Universität MünchenIsmaninger Straße 2281675 München, Germany
Germer, Christoph-T., Prof. Dr.Klinik & Poliklinik für Allgemein-und Viszeralchirurgie, Gefäß- undKinderchirurgieUniversitätsklinik Würzburg Oberdürrbacher Straße 697080 Würzburg, Germany
Gralnek, Ian, Prof. Dr. FASGEDepartment of GastroenterologyRambam Health Care CampusRappaport Faculty of MedicineTechnion-Israel Institute ofTechnology8 Ha'Aliyah StreetHaifa, 35254, Israel
Hawes, Rob, MD PhD FASGECenter for InterventionalEndoscopyFlorida Hospital Orlando610 East Rollins StOrlando, FL 32803, USA
Hochberger, Jürgen, Prof. Dr.Département de Hépatogastro -entérologie, HôpitauxUniversitaires de StrasbourgNouveau Hôpital Civil1 Place de l'Hôpital - BP 42667091 Strasbourg Cedex, France
Jähne, Joachim, Prof. Dr. Klinik für Allgemein- undVisceralchirurgieDiakoniekrankenhausHenriettenstiftung gGmbHMarienstraße 72-9030171 Hannover, Germany
Jovanovic, Ivan, MD, PhDAss. Professor of InternalMedicine, Medical School,University of BelgradeClinic for Gastroenterology andHepatologyClinical Center of Serbia2 Koste Todorovic Street11 000 Belgrade, Serbia
Jung, Michael, Prof. Dr. FRCPKlinik für Innere MedizinGastroenterologie, Onkologie u.DiabetologieSt. Hildegardis KrankenhausHildegardstraße 255131 Mainz, Germany
Kähler, Georg, Prof. Dr.Leiter der ZentralenInterdisziplinären Endoskopie Universitätsmedizin Mannheim Medizinische Fakultät derUniversität Heidelberg Theodor-Kutzer-Ufer 1-3 68167 Mannheim, Germany
Lehmann, Kai, Dr.Klinik für Allgemein-, Gefäß- undThoraxchirurgie Charité – Campus BenjaminFranklinHindenburgdamm 3012200 Berlin, Germany
Meier, Peter N, Dr. FASGEMedizinische Klinik II -GastroenterologieDiakoniekrankenhausHenriettenstiftung gGmbHSchwemannstraße 1730559 Hannover, Germany
14
3. International Symposium on Complications in GI Endoscopy
Faculty
Facu
lty
Meining, Alexander, Prof. Dr.II. Medizinischen KlinikKlinikum rechts der IsarTechnische Universität MünchenIsmaninger Straße 2281675 München, Germany
Meisner, Søren, MDHead of GI Endoscopy UnitBispebjerg University HospitalBispebjerg Bakke 232400 Copenhagen NV, Denmark
Mergener, Klaus, MD, PhD, MBADirector, GI Hospitalist ServicesDigestive Health SpecialistsClinical Medical Director,GastroenterologyMultiCare Health SystemTacoma, Washington, USA
Messmann, Helmut, Prof. Dr.III. Medizinische Klinik mit S.GastroenterologieKlinikum AugsburgStenglinstraße 286156 Augsburg, Germany
Meyenberger, Christa, Prof. Dr.Ärztliche LeitungGastroenterologie Department Innere Medizin-Haus 01Kantonsspital St. Gallen9007 St. Gallen, Switzerland
Neumann, Helmut, Prof. Dr.Medizinische Klinik 1Interventionelle EndoskopieUniversitätsklinikum ErlangenUlmenweg 1891054 Erlangen, Germany
Neye, Holger, Dr.HELIOS Klinikum Emil von Behring Klinik für Innere Medizin IIWalterhöferstraße 1114165 Berlin, Germany
Ortmaier, Tobias, Prof. Dr.-Ing. Leibniz Universität Hannover Institut für MechatronischeSystemeAppelstr. 11a30167 Hannover, Germany
Pohl, Jürgen, Prof. Dr.HSK Dr.-Horst-Schmidt-KlinikenII. Medizinische KlinikLudwig-Erhard-Straße 10065199 Wiesbaden, Germany
Ponchon, Thierry, Prof. Dr.Hôpital Eduard HerriotSpecialité Digestive, Pavillon HPlace d’Arsonval69437 Lyon, France
Ragunath, Krish, MD DNB MPhilFRCP(Edin) FRCP(Lond), Notting -ham Digestive Diseases Centre,NIHR, Queens Medical CentreCampus, Nottingham UniversityHospitals NHS TrustNottingham NG7 2UH, UK
Reddy, Nageshwar, Prof. Dr.ChairmanAsian Institute of Gastroenterology6-3-661, Somajiguda,Hyderabad - 500 082, India
Rotondano, Gianluca, MD FASGEFACG, Division of GastroenterologyHospital Maresca Via Cappella Vecchia 880121 Napoli, Italy
Schreiber, Florian, Prof. Dr.Klin. Abt. für Gastroenterologieund Hepatologie, Universitätsklinikfür Innere Medizin, MedizinischeUniversität GrazAuenbruggerplatz 158010 Graz, Austria
Schulz, Hans-Joachim, Prof. Dr.Klinik für Innere Medizin I, Gastro -enterologie und AkutgeriatrieSana-Klinikum LichtenbergFanningerstraße 3210365 Berlin, Germany
Seufferlein, Thomas, Prof. Dr.Klinik für Innere Medizin IZentrum für Innere MedizinUniversitätsklinikum UlmAlbert-Einstein-Allee 23, 89070 Ulm, Germany
Siersema, Peter, Prof. Dr.Academisch Ziekenhuis UtrechtAfd. GastroenterologieHeidelberglaan 1003584 CX Utrecht, Netherlands
Tamm, RüdigerSenior Product ManagerGastroenterology Gastroentero lo gy and RespiratoryEndoscopyMedical Systems DivisionOlympus Europa Holding GmbHWendenstraße 14-1820097 Hamburg, Germany
Weber, Josef, Dr.Centre Hospitalier LuxembourgDept. Hepatogastroenterologie4, rue Barblé1210 Luxembourg, Luxembourg
Wehrmann, Till, Prof. Dr.Fachbereich GastroenterologieStiftung Deutsche Klinik fürDiagnostikAukammallee 3365191 Wiesbaden, Germany
Williams, Christopher, BM FRCPFRCSEndoscopy UnitThe London ClinicLondon, W1N 2DHUK
Wunn, Ina, Prof. Dr. Dr.G. W. Leibniz-UniversitätHannoverLeinstraße 830159 Hannover, Germany
15
28-29 June 2013
Faculty
Faculty
Postbox 10 49 08, 20034 Hamburg, Germany | Tel. +49 40 23773-0 | www.olympus-europa.com
In the pursuit of the perfect endoscopy system, Olympus introduces EVIS EXERA III
as the next milestone towards improved clinical outcomes.
For more information, please visit www.olympus-europa.com/EXERA3
EVIS EXERA IIIAdvancing the Art of Endoscopy.
3. International Symposium on Complications in GI Endoscopy28 - 29 June 2013, Maritim Airport Hotel Hannover
Please use capital letters.
Title Prof. Dr. Mrs. Mr.
First name _____________________________________________________________________________________________
Family name _____________________________________________________________________________________________
Institution, Department _____________________________________________________________________________________________
Street _____________________________________________________________________________________________
Postal Code _____________________________________________________________________________________________
City/Country _____________________________________________________________________________________________
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Statistics: Office-based physician Hospital-based physician
Specialisation: Gastroenterology Surgery Internal Medicine Others: __________________________________________
REGISTRATION FEE UNTIL 15 APRIL 2013 FROM 16 APRIL 2013
Physician 160,- € 220,- € Nurse 40,- € 70,- € Student 40,- € 70,- € Team (1 physician and max. 2 nurses) 190,- € 250,- €
Please fill in one form for each team member!
ESGE individual member (please tick)
Please choose one of the following working groups, 28 June 2013 from 16:30 to 18:00 (no extra charge)
WG 1: EMR/ESD/NOTES WG 4: Instruments and accessories WG 2: Colonoscopy WG 5: EUS WG 3: ERCP WG 6: Patientensicherheit in der Endoskopie (in German)
Registration fee total: ____________
RECEPTION AND DINNER at the Town Hall Garden Restaurant on 28 June 2013
Participant: 30,- € Accompanying person: 45,- €
Dinner fee total: ____________
HOTEL BOOKING, Maritim Airport Hotel Hannover (Flughafenstr. 5, 30669 Hannover)
Check in _____ June 2013 Check out _____ June 2013 = _____ nights Rates are per room and night, incl. breakfast, service and VAT.
single room 119,- € double room 158,- € Estimated arrival time: _______________
Special wishes: non-smoking room smoking room
______________________________________________________________________________________
Hotel fee total: ____________
TOTAL AMOUNT: ____________
Online registration under: www.complications-in-endoscopy.com
REGISTRATION
Please register via our website www.complications-in-endoscopy.com or complete this registration form and fax it to +49 (0)89 / 89 06 77-77. The final registration date is 21 June 2013. Please register after this date on site.
CANCELLATION
Congress Registration
Cancellation in written must be received not later than 14 June 2013. A service fee of 20.- € will be deducted from the refundamount. Registration fees will not be refunded if cancellations are received at a later date.
HOTEL RESERVATION
We kindly ask you to settle all additional expenses during check out at the hotel.
Changes in reservation and cancellations must be reported in written to COCS GmbH (not to the hotel). If the guest cancels areservation prior to 26 April 2013 a cancellation fee of 20,- € per room reservation and per night will be charged; any bank chargesthat may arise as a result of such a cancellation will be covered by the guest him-/herself. After that date, COCS GmbH and thehotel certainly try to resell cancelled rooms, but if this is not possible the cancellation fee of the hotel (up to 100% of the roomrate) will be charged to you.
Please also be aware in the case of a later arrival or an earlier departure some hotels will charge you the total number of nightsbooked, if the nights cannot be resold.
PAYMENT
Please choose between bank transfer or credit card payment.
bank transfer
Please pay the total amount to the following account:
Account holder: COCS GmbHBank name: HypoVereinsbank MünchenBank code: 700 202 70Account: 39613140IBAN: DE30 7002 0270 0039 6131 40BIC: HYVEDEMMXXXReference: CIE2013 & name of the participant
All bank charges must be covered by the participantsdirectly.
credit card (Visa or Master)
_________________________________________Name of credit card holder
_________________________________________Credit card number
_________________________________________Exp. Date (Month/Year)
I hereby authorize COCS GmbH to charge the total amountfrom the credit card.
_____________________________________________________________________________________________________________________Date, Signature
For further questions, please do not hesitate to contact:COCS GmbH – Congress Organisation C. Schaefer – Rosenheimer Str. 145c – 81671 Munich, GermanyTel: +49 (0)89 / 89 06 77-23 – Fax: +49 (0)89 / 89 06 77-77 – E-Mail: [email protected]