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Vienna 2019 Registration form
This is the registration form for the fourth conference of the CCM Association (Vienna 2017).
First name: *
Last name: *
Psychoanalytic Society or Group: *
Years since qualification: *
E-mail address: *
Address (line 1): *
City: *
Country: *
Postcode / ZIP: *
How many times (if ever) did you attend a CCM group before? *
Any special comments?
Terms and Conditions
I am a member of the International Psychoanalytic Association. If I wish to cancel my place after it is accepted and outside of any period in which I might have a right to cancel, then the following applies: My cancellation must be received in writing no later than 28 days before the start of the event to rue Caroline 7, 1003 Lausanne . If you receive my cancellation no later than 28 days before the start of the event you will refund any amount I have paid to you for that event less an administration charge of 20%. No refunds will be made for cancellations made by me within 28 days of the event date.
Tick to agree with the terms and conditions *
Required
The fee is 290 Euros for participants enrolled before February 28 2019; 350 Euros thereafter. Tick to confirm payment is being sent sent today to: CCM Clinical Comp Meth. Postal address is : rue Caroline 7, 1003 Lausanne but the best method for payment is by Internet transfer or by visiting your own bank (depending on your local arrangements) to: Banque Cantonale Vaudoise, Place St Francoise 14, CH 1002 Lausanne SWIFT: BCVLCH2LXXX and IBAN CH57 0076 7000 C532 8738 4 *
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