Registration and Submission Form_ISR2017

In ternational System ic Research Conference 2017
“Linking System ic Research and Practice”
REGISTRATION and SUBMISSION FORM
International Systemic Research Conference 2017
“Linking Systemic Research and Practice”
University of Heidelberg, Germany
March 8 – 11, 2017
Personal Details – please print
M s. / M rs. / M r. / Dr. / Prof.
Surnam e
First Nam e
Address
Organization
Postal/Zip code
City
Country
Telephone
Fax
E-M ail address
Abstract Submission (please submit until February 28 to be
included in the program version April 2016)
o
I want to organize a symposium or panel / debate (60 or 90 minutes)
Title:
(Please send abstract separately)
o
I want to give a brief oral presentation (15 minutes)
Title:
(Please send abstract separately)
o
I want to exhibit and discuss a research poster
Title:
(Please send abstract separately)
o
I want to present a research methodology workshop (60 minutes)
Title:
(Please send abstract separately)
Guidelines for abstract submission
Please prepare your abstract in English, using single line spacing and Times New
Roman font size 12. Abstracts should be submitted as word documents. The
maximum word count is 300, excluding title, authors´ names and affiliations. The
name of the presenting author should be underlined. Please include full contact
details for this author.
Conference Registration
All presenters are required to register for the conference and to pay the applicable
registration fee. In case of joint authorships, if the primary author is unable to attend
and has made arrangements for someone else to present, that person must register
and pay the applicable registration fee.
Conference Fees
(based on OECD classification of per capita incomes by countries)
until
until
until
from
April 30,
Sept 30,
Dec 30,
Jan 1,
2016
2016
2016
2017 on
High income countries, regular fee
230 €
260 €
290 €
320 €
High income countries, reduced fee
190 €
220 €
250 €
280 €
Middle Income Countries, regular fee
80 €
100 €
120 €
120 €
Low income countries, regular fee
20 €
40 €
60 €
80 €
Bachelor / Master Students and currently
20 €
40 €
60 €
80 €
10 €
20 €
30 €
40 €
(sponsoring associations members) *
unemployed colleagues from high income
countries*
Bachelor / master students and currently
unemployed colleagues from mid and low
income countries *
* Please provide respective documents
High-income countries (above 20.000 USD) include: Europe (North, West, Central West,
Italy), North America (USA and Canada), Australia and New Zealand, South- East Asia
(Japan,
South
Korea,
Singapore,
Taiwan,
Hongkong,
Brunei
only),
Gulf
States
(Saudia Arabia, Kuwait, Emirates, Oman only)
Mid-income countries (between 8.000 and 20.000 USD): Europe (East, Central East, South
except Italy), South-East Asia (China, Thailand, Malaysia only), South America (Chile, Brazil,
Uruguay, Argentina only)
Low income countries (below 8.000 USD): All other countries
Members of sponsoring associations, university students and currently unemployed
colleagues must submit some document of belonging to that category of registrants.
Payment Details
Conference payment is accepted only through bank transfer!
Beneficiary Account:
Klinikum der Unversitaet Heidelberg
IBAN:
DE64 6005 0101 7421 5004 29
BIC:
SOLADEST600
Reference:
D. 100 825 30
(please make sure to include this number)
Please note: If your dues are paid separately by someone else, please enter that person’s
name here:
We kindly ask you to transfer the registration fees no later than 2 weeks from the registration
date.
Bank nam e and address:
BW Bank Stuttgart
Kleiner Schlossplatz 11
D-70173 Stuttgart
Registration Cancellations and Refunds
All cancellations and changes to registrations need to be made in written form by
email, fax or post. All cancellations received in writing before January 31, 2017 will
be accepted, and registration fees refunded apart from a € 30 administration fee.
Regrettably, no refunds can be given after this date, however substitute delegates
are most welcome with written notification.
Accommodation
For your comfortable stay in Heidelberg during we recommend two options for
inquiry:
Heidelberg Tourism Service
Guest Room Centre
Phone: 0049 (0) 6221 58402 26
Phone: 0049 (0) 6221 160363
Fax: 0049 (0) 6221 160363
Mail: [email protected]
Web:
http://www.gaestezimmerzentrale.biz/gäst
ezimmer-zentrale-english/
Fax: 0049 (0) 6221 58402 22
Web: [email protected]
Link: http://www.heidelbergmarketing.com/hotels/hotelbooking.html
The conference is organized by
Institute of Medical Psychology, Heidelberg University
In cooperation with (in alphabetical order)
American Academy of Family Therapy (AFTA), Chinese Mental Health Association,
Systemic Therapy Branch, European Association of Family Therapy (EFTA), German
Society for Systemic Therapy, Consultation and Family Therapy (DGSF), Helm Stierlin
Institute (HSI), Systemische Gesellschaft (SG), and others
Conference Presidents: Prof. Dr. Jochen Schweitzer, Prof. Dr. Matthias Ochs
Please
send
your
registration,
your
abstract
and
information of the presenting author to:
International Systemic Research Conference
c/o Institute of Medical Psychology
Bergheimer Str. 20
D-69115 Heidelberg, Germany
[email protected]
0049 (0) 6221 568185
All upcoming program versions will be available on
www.systemisch-forschen.de
contact