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Scientific programme endorsed by IHS WG on ACC 9th International Conference Acute Cardiac Care January 18-20, 2015 Tel Aviv, Israel CME Accredited www.acute-cardiac-care.com ISRAEL HEART SOCIETY 2 Steering Committee Organized in Collaboration with Joseph S. Alpert, USA, Co-Chair Yonathan Hasin, Israel, Co-Chair Doron Zahger, Israel, Co-Chair Zaza Iakobishvili, Israel, Secretary General Shlomo Matetzky, Israel, Scientific Secretary Ofra Raanan, Israel, Nursing Coordinator Avishay Elis, Israel, Internal Medicine Giora Landesberg, Israel, Anesthesiology Christiaan Vrints, Acting Past President, ESC Acute Cardiovascular Care Association Invited Faculty Joseph S. Alpert, USA Ezra Amsterdam, USA Pierre Asfar, France Yochai Birnbaum, USA Andrzej Budaj, Poland Hector Bueno, Spain Filippo Crea, Italy Uri Elkayam, USA Jeffrey Goldberger, USA John Horowitz, Australia Kurt Huber, Austria Tiny Jaarsma, The Netherlands Allan Jaffe, USA Sanjay Kaul, USA Maddalena Lettino, Italy Ranveig Lind, Norway Alan Maisel, USA Simon Matskeplishvili, Russia Barbara McLean, USA Guy Meyer, France Kjell Nikus, Finland Wanda Popescu, USA Susanna Price, UK Claudio Sandroni, Italy Alexander Shpektor, Russia Gabriel Steg, France Elena Vasilyeva, Russia Christiaan Vrints, Belgium Uwe Zeymer, Germany European Resuscitation Council Local Faculty and Organizing Committee Arnon Afek Ronny Alcalai Doron Aronson Elad Asher Abid R. Assali Shaul Atar Jonathan Balkin Shahar Bar Yosef Roy Beigel Tuvia Ben Gal Julie Benbenishty Shlomo Berliner Alex Blatt Gil Bolotin Natan Bornstein Carlos Cafri Haim Dannenberg Dror Diker Idit Dobrecky-Mery Robert Dragu Sharon Einav Avishay Elis Paul Feffer Ariel Finkelstein Jeffrey Fisher Moshe Flugelman Shmuel Fuchs Anat Gafter Jacob George Dan Gilon Harel Gilutz Michael Glikson Sorel Goland Ilan Goldenberg Jacob Goldstein Gregory Golovchiner Shmuel Gottlieb Elli Gutterman Moti Haim Haim Hammerman David Hasdai Tal Hasin Hanoch Hod Zaza Iakobishvili Reuben Ilia Ronen Jaffe Michael Kapeliovich Amos Katz Andre Keren Gad Keren Ran Kornowski Oscar Kracoff Michael Kriwisky Giora Landesberg Jacob Lavee Eli Lev Philip Levine Ron Lior Chaim Lotan Shlomi Matetzky Simcha Meisel Morris Mosseri Daniel Murninkas Menachem Nahir Eyal Nof David Pereg Azriel Perel David Planer Arthur Pollak Avital Porter Guy Raphaeli Eldad Rehavia Arie Roth Yoseph Rozenman Eyal Robenshtok Alex Sagie Amit Segev Aryeh Shalev Avi Shimony Avi Shotan Pierre Singer Zvi Vered A. Teddy Weiss Giora Weisz Arik Wolak Doron Zahger 3 Dear Colleague, The 9th International Conference on Acute Cardiac Care will be held in Tel Aviv on January 18-20, 2015. The Cardiology Conference will feature three parallel medical streams, with over 100 presentations, including: satellite symposia, keynote and plenary lectures, debates, clinical interactive case presentations and poster presentations over two days. In addition to the medical streams, there will be a parallel nursing stream. The program is diverse and includes content that will satisfy all participants interested in acute cardiac care. The Cardiology Conference will be held under the auspices of the Israel Heart Society (IHS), and in collaboration with the ESC Acute Cardiovascular Care Association, the ERC European Resuscitation Council, the Israel Working Group on Acute Cardiac Care of the IHS, the Israeli Association for the Advancement of Cardiac and Intensive Care Nursing, the Israel Society of Internal Medicine and the Israel Society of Anesthesiologists. We look forward to your attending this 9th International Conference with state of the art scientific sessions and entertaining social and cultural events. A full array of pre- and post-conference tours is offered, including: Jerusalem and its holy places; United Nation Heritage sites such as Masada, the Dead Sea, Caesaria and Acco; as well as many other historical, religious and archeological sites. We hope you will join us. Sincerely, Joseph S. Alpert Yonathan Hasin Doron Zahger 18 Scientific Program Monday, January 19, 2015 08:30-10:00 STEMI - Pre-hospital Hall A management Chairs: D. Ganem, Z. Vered, Israel 8:30 Pre-hospital anticoagulants and anti-platelets in STEMI C. Vrints, Belgium 8:48 STEMI networks of the world D. Hasdai, Israel 9:06 Non-ischemic ST elevation challenges for the STEMI networks Y. Birnbaum, USA 8:30 Diagnostic approach and risk stratification H. Hod, Israel 8:48 Lessons from PEITHO trial G. Meyer, France 9:06 Surgical treatment of acute pulmonary embolism G. Bolotin, Israel 9:24 New oral anticoagulants A. Shimony, Israel 9:42 Percutaneous intervention G. Weisz, Israel 9:24 Pre-hospital thrombolysis: For whom? A.T. Weiss, Israel Nursing Session: Hall D Patient bedside care Chair: J. Benbenishty, Israel 9:42 Remote ischemic preconditioning in ACS A. Shpektor, Russia 8:30 Greetings O. Raanan, Israel 8:40 Challenges to the patientpartner relationship when dealing with progressive heart failure T. Jaarsma, Netherlands 9:00 Lactate and thiamine are significant players R. Vaya, Israel 9:20 The meaning of follow-up in intensive care: The patient’s perspective R. Lind, Norway 9:40 C.O poisoning and severe cardiac failure - case presentation M. Kuniavsky, Israel Acute reperfusion – Hall B controversies Chairs: U. Rozenshein, J. George, Israel 8:30 9:15 Stroke: Interventional treatment G. Raphaeli, Israel Thrombolysis N. Bornstein, Israel Bivalirudin for all STEMI Pro: P.G. Steg, France Con: S. Kaul, USA Acute pulmonary Hall C embolism Chairs: H. Hod, M. Kapelovich, G. Weisz, Israel Scientific Program Monday, January 19, 2015 10:00-10:30 Coffee break and poster session 10:30-11:30 Opening and Plenary Session Hall D 10:30-10:50 Greetings A. Afek Israel Ministry of Health J. Alpert, Y. Hasin Conference Chairmen H. Bueno President of ACCA of ESC Y. Rozenman President, Israel Heart Society O. Raanan Nursing Coordinator 10:50-11:30 Keynote Lecture Moving targets in intensive care P. Asfar, France 11:30-13:15 Mechanisms and Hall A management of reperfusion injury and microvascular obstruction Chairs: M. Flugelman, J. Leor, C. Lotan, Israel 19 12:30 Device strategies for prevention of no reflow H. Dannenberg, Israel 12:50 Inflammation and platelet reactivity E. Vasilieva, Russia Managing chest pain in Hall B the emergency room Chairs: H. Hammerman, M. Eldar, R. Lior, Israel 11:30 Role of the chest pain unit R. Beigel, Israel 11:50 Role of the ECG K. Nikus, Finland 12:10 Debate: CTA should be the standard screening test for low risk patients presenting to the emergency department with chest pain Pro: A. Shalev, Israel Con: E. Amsterdam, USA 12:55 Copeptin use in patients presenting with chest pain: Results of CHOPIN A. Maisel, USA 11:30 Distal coronary embolization: Scope of the problem R. Jaffe, Israel General intensive care Hall C in acutely ill cardiac patient Chairs: M. Klein, H. Gilutz, Israel 11:50 Increased coronary resistance in ACS F. Crea, Italy 11:30 Nutrition of critically ill acute cardiac patients P. Singer, Israel 12:10 Pre- and post-ischemic conditioning in ACS - update Y. Birnbaum, USA 11:50 Non-invasive ventilation TBA 20 Scientific Program Monday, January 19, 2015 12:10 Assessment of fluid responsiveness A. Perel, Israel 12:30 High vs. low mean blood pressure target in the management of sepsis lessons for the cardiac patients P. Asfar, France 12:50 The importance of proper sedation in ICU patients P. Levine, Israel Nursing Session: Hall D Symptom relief and patient centered care Chair: D. Levy, Israel 11:30 Bedside cardiac monitoring for all practice settings: Implementing evidence at the point of care B. McLean, USA 12:00 Case presentation of cervical fractures R. Targon, Israel 11:20 Symptom management when caring for the patient at endof-life M. Ben-Nun, Israel 12:45 Pain, sedation and delirium daily challenges S. Ashkenazi, Israel 13:15-15:10 Luncheon Symposium New frontiers in Hall E cardiology Chairs: A. Pollak, G. Weisz, Israel Dabigatran as part of “Triple” therapy in patients suffering from acute coronary syndrome and atrial fibrillation - conclusions from clinical trial and real-world data A. Pollak, Israel Sponsored by Boehringer Ingelheim Renal denervation therapy is still the viable option after SIMPLICITY III G. Weisz, Israel Sponsored by Medtronic Current issues in the Hall F use of new anti-platelet therapies in ACS Chair: S. Matetzky, Israel 13:15 Get together 13:40 The immediate effect of new antiplatelet agents in patients with ACS: Should we preload the patient? E. Lev, Israel 14:00 The contemporary use of new antiplatelet agents: Barriers and clinical benefits S. Matetzky, Israel 14:20 Case presentation A. Shimony, Israel 14:30 Panel discussion and lunch Sponsored by Lilly Scientific Program Monday, January 19, 2015 15:10-16:40 Peri-operative cardiology Hall A Chairs: G. Landesberg, I. Dobrecky Meri, M. Mosseri, Israel 15:10 High risk coronary patients for non-cardiac surgery G. Landesberg, Israel 15:28 Indications for echocardiography before noncardiac surgery S. Bar Yosef, Israel 15:46 Preoperative assessment of GUCH patients before noncardiac surgery S. Price, UK 16:04 How to manage the patient on DAPT before non-cardiac surgery W. Popescu, USA 21 16:22 Who needs a permanent pacemaker M. Glikson, Israel Cardiovascular Hall C emergencies in pregnancy Chairs: A. Shotan, D. Aronson, Israel 15:10 Risk of subsequent pregnancy in women with a history of peripartum cardiomyopathy U. Elkayam, USA 15:32 Non-peripartum dilated cardiomyopathy in pregnancy A. Shotan, Israel 15:54 Prosthetic valve emergencies in pregnancy S. Goland, Israel 16:16 Peripartum ACS management A. Porter, Israel 16:22 Elevated troponin in the ICU and post-op patients A. Jaffe, USA Nursing Session: Comfort management Chair: R. Halilah, Israel TAVI - issues for the ICCU Hall B Chairs: Y. Rozenman, J. Balkin, Y. Hasin, Israel 14:00 End-of-life care of patient with ACD S. Laufer, S. Truman, Israel 15:10 Patient selection: Surgery, TAVI, valvuloplasty, conservative A. Finkelstein, Israel 14:15 Why do we care about cardiac output? Determine the endpoints B. McLean, USA 15:28 Anesthetic considerations J. Fisher, Israel 14:45 Last resort: ECMO B. Mutzlach, Israel 15:46 Residual aortic regurgitation D. Planer, Israel 15:00 Professional bedside perspective of ICU hospital experience T. Halabi, Israel 16:04 Major vascular complications A. Segev, Israel Hall D 22 Scientific Program Tuesday, January 20, 2015 08:30-10:00 STEMI - controversies Chair: D. Zahger, Israel 8:48 NSTE-ACS in special populations: Women A. Jaffe, USA Hall A 8:30 Aspiration Pro: C. Cafri, Israel Con: A.R. Assali, Israel 9:06 NSTE-ACS in special populations: Renal failure D. Aronson, Israel 9:05 IABP in cardiogenic shock Pro: D. Zahger, Israel Con: U. Zeymer, Germany 9:24 NSTE-ACS in special populations: Diabetes S. Matskeplishvili, Russia 9:40 Culprit only versus multivessel PCI in STEMI A. Budaj, Poland 9:42 Invasive vs. conservative management of patients with NSTE-ACS: The benefit of optimal medical management E. Amsterdam, USA Anti-platelets in ACS Hall B an update Chairs: S. Matetzky, R. Alkalay, A. Pollak, Israel 8:30 Impact of platelet function assays on clinical outcome and practice S. Matetzky, Israel 8:52 Current role of intravenous antiplatelet agents E. Asher, Israel 9:14 Combining antiaggregant and anticoagulant therapy in patients with ACS and atrial fibrillation E. I. Lev, Israel 9:36 Real world usage of novel P2Y12 inhibitors for ACS clinical experience and post marketing data H. Bueno, Spain NSTE-ACS Hall C Chairs: M. Halabi, J. Goldstein, S. Meisel, Israel 8:30 Timing of intervention M. Lettino, Italy Nursing Session: Medications effects Chair: L. Jacobson, Israel Hall D 8:30 Greetings O. Raanan, Israel 8:45 Everyday medications and the cardiac side effects D. Benluk, M. Sadi, Israel 9:05 Side effects and medication adherence: How to measure and how to intervene T. Jaarsma, Netherlands 9:30 National study on nurse bullying in ICU F. DeKeysar, Israel 9:45 Gender aspects of cardiac disease Y. Drori, Israel 10:00-10:20 Coffee break and poster session Scientific Program Tuesday, January 20, 2015 10:20-11:45 Plenary Session Hall D How solid are the guidelines? A critical review of the ACS guidelines S. Kaul, USA Palliative care in the ICCU - Panel discussion Chair: Y. Hasin, Israel S. Atar, M. Ben-Nun, F. DeKeysar, E. Dolev, M. Halperin, A. Nimrod 11:45-13:15 The cardiac patient in the Hall A internal medicine ward Chairs: D. Pereg, D. Diker, A. Elis, Israel 11:45 Heart failure with preserved left ventricular ejection fraction T. Hasin, Israel 12:03 Iron and other micronutrients in the cardiac patient A. Gafter, Israel 12:21 Treatment of endocrinopathies in acute cardiac patients E. Robenshtok, Israel 12:39 Type II MI: Epidemiology, management J. Alpert, USA 12:57 Use of procalcitonin in the acutely dyspneic patient A. Maisel, USA Cardiac arrest - out-ofHall B hospital and in-hospital Chairs: D. Hasdai, M. Kriwisky, Z. Iakobishvili, Israel 23 11:45 Insights from registries Z. Iakobishvili, Israel 12:03 CPR - can we do better? S. Einav, Israel 12:21 Dilemmas in hypothermia after OHCA C. Sandroni, Italy 12:39 In-hospital cardiac arrest C. Sandroni, Italy 12:57 Early coronary angiography after sudden death - for whom? D. Hasdai, Israel Acute heart failure Hall C Chairs: O. Amir, G. Keren, E. Rehavia, Israel 11:45 Telemonitoring for the prevention of rehospitalization T. Ben Gal, Israel 12:03 New pharmacologic options U. Elkayam, USA 12:21 Interatrial decompression device for the treatment of systolic and diastolic heart failure G. Keren, Israel 12:39 The role of mitraclip P. Feffer, Israel 12:57 Mechanical support D. Murninkas, Israel 24 Scientific Program Tuesday, January 20, 2015 Nursing Session: Hall D Protocols and guidelines- what should we follow? Chair: F. DeKeysar, Israel 15:10-16:40 Controversial issues in Hall A arrhythmia management Chairs: A. Katz, B. Strasberg, Israel 11:45 Why should nurses care about guidelines in the first place? T. Jaarsma, Netherlands 15:10 Early arrhythmias in STEMI and their prognostic impact G. Golovchiner, Israel 12:00 End stage heart failure nursing issue allowing a dignified death M. Bartal, Israel 15:28 Wearable defibrillator I. Goldenberg, Israel 12:20 Past present and future of CCU nursing S. Shibli, R. Yeshayahu, Israel 12:40 ICU diaries and their role in preventing ICU PTSD R. Lind, Norway 13:00 After long term ICCU hospitalization - clinical aspects R. Yaish, Israel 13:15-15:10 Luncheon Symposium Comparison of Apixaban, Hall E Dabigatran and Rivaroxaban in the acute treatment and prevention of venous thromboembolism S. Berliner, Israel Sponsored by Pfizer New and upcoming data Hall F regarding Ticagrelor in ACS and PCI G. Steg, France Sponsored by AstraZeneca 15:46 Early ICD implantation after acute myocardial infarction J. Goldberger, USA 16:04 Management of electrical storm E. Nof, Israel 16:22 Complications after EP procedures M. Haim, Israel Meet the experts - Case Hall D presentations Presented by resident doctors Chairs: A. Battler, Israel J. Alpert, USA 15:10 STEMI S. Moanis, Israel Discussant: A. Bodaj, Poland 15:32 NSTEMI S. Baruoha, Israel Discussant: E. Amsterdam, USA 15:54 Acute heart failure, aortic stenosis in the surgical patient A. Samara, Israel Discussant: G. Landesberg, Israel Scientific Program Tuesday, January 20, 2015 16:16 Myocarditis I. Mahamid Abomouch, Israel Discussant: A. Keren, Israel Acute non-coronary Hall C patients in the ICCU Chairs: S. Gottlieb, O. Kracoff, Israel 15:10 Endocarditis: Who needs early surgery S. Matskeplishvili, Russia 15:32 Prosthetic valve emergencies A. Sagie, Israel 15:54 Dilemmas in the diagnosis and management of aortic dissection D. Gilon, Israel 16:16 Takotsubo cardiomyopathy: What’s new in 2015 J. Horowitz, Australia Nursing Session: Hall D The many faces of cardiac critical care Chair: O. Kolpak, Israel 14:15 Families’ experiences of endof-life decision-making in the ICU R. Lind, Norway 14:40 Improving weaning process using evidence based nursing protocol L. Jacobson, Israel 15:00 Palliative care in intensive care - summary of national course O. Raanan, Israel 25 11 Program at a Glance Monday, January 19, 2015 Hall A Hall B Acute 08:30-10:00 STEMI Pre-hospital reperfusion - Hall C Acute pulmonary management controversies embolism 10:00-10:30 Coffee break and poster session 10:30-11:30 Opening and Plenary Session Hall D Managing General 11:30-13:15 Mechanisms and management of chest pain in the intensive care reperfusion injury emergency room in acutely and microvascular ill cardiac patient obstruction 13:15-15:10 Luncheon Symposium: Sponsored by Boehringer Ingelheim/Medtronic Hall E Sponsored by Lilly Hall F 15:10-16:40 Peri-operative TAVI - issues for Cardiovascular cardiology the ICCU emergencies in pregnancy Tuesday, January 20, 2015 Hall A Hall B 08:30-10:00 STEMI Anti-platelets controversies in ACS - an update 10:00-10:20 Coffee break and poster session 10:20-11:45 Plenary Session Hall D 11:45-13:15 The cardiac patient Cardiac arrest in the internal out-of-hospital medicine ward and in-hospital 13:15-15:10 Luncheon Symposium: Sponsored by Pfizer Hall E Sponsored by AstraZeneca Hall F Meet the experts 15:10-16:40 Controversial issues in arrhythmia management Hall D Nursing Session I Nursing Session II Nursing Session III Hall C NSTE-ACS Hall D Nursing Session IV Acute heart failure Nursing Session V Acute noncoronary patients in the ICCU Nursing Session VI Subject to change. For updates: www.acute-cardiac-care.com 12 General Information Website: www.acute-cardiac-care.com Please view periodically for updates. Venue: David Intercontinental Hotel 12 Kaufman Street, Tel Aviv Tel: +972-3-7951111 Language: The official language of the Conference is English. Get-Together Tour and Reception: Sunday, January 18 18:00 Depart from venue hotel for night tour and cocktail reception at Nachum Gutman Museum of Art, 21:30 Return Price: $80 Tour and Festive Dinner: Tour and Festive Dinner: Monday, January 19 19:00 Depart from venue hotel 19:30 Gala dinner, 22:30 Return Price: $120 CME: The event 9th International Conference of Acute Cardiac Care. is accredited by the European Board for Accreditation in Cardiology (EBAC) for 10 hours of External CME credits. Each participant should claim only those hours of credit that have actually been spent in the educational activity. EBAC works according to the quality standards of the European Accreditation Council for Continuing Medical Education (EACCME), which is an (institution of the European Union of Medical Specialists UEMS). Participants who wish to receive CME credits must register daily upon entry and departure. CME credit is dependent upon registration at the CME desk. In compliance with EBAC/ EACCME guidelines, all speakers/ chairpersons participating in this programme have disclosed potential conflicts of interest that might cause a bias in the presentations. The Organising Committee is responsible for ensuring that all .potential conflicts of interest relevant to the programme are declared to the audience prior to the CME activities. Sponsored lunch symposia do not qualify for CME accreditation Exhibition: A commercial exhibition will be held within the framework of the Conference. Exhibitors will be provided with an unprecedented opportunity to promote innovative products, pharmaceuticals, equipment and technologies to a discerning international professional audience. For further information contact the Secretariat at [email protected] Industrial Sponsorship: Satellite symposia, sponsored lectures and working luncheons will be held during the Conference. Request for industrial sponsorships should be sent to [email protected] Letters of Invitation: Upon request, the Secretariat will send a personal invitation to participate in the conference. Such an invitation is only meant to help visitors raise travel funds or obtain a visa and is not a commitment to provide financial support. Transportation from Airport: Ben-Gurion International Airport is located 20 minutes from Tel Aviv. Airport train ($10) and private taxi service ($45) provide fast and economic transportation. Visas: All visitors to Israel are required to have a valid passport, and for some countries, a visa is required. For more information please contact your nearest embassy, consulate or local travel agency well in advance. It is the responsibility of the participant to obtain a visa if required. Currency / Exchange: Israel’s currency is the New Israeli Shekel (NIS). International major credit cards are accepted in most hotels, restaurants and shops. Exchange offices and ATM machines are easily available throughout the city and at the Ben-Gurion International Airport. Climate: The weather in January is cool with possible rain, temperatures ranging from 6-14°C / 45-60°F. Clothing: Clothing is informal for all occasions. A sweater or jacket is also recommended, as the conference rooms may be cool. Important Notes: ISAS International Seminars, and their agents, shall not be responsible for and shall be exempt from all liability in respect of any loss, damage, injury, accident, delay or inconvenience to any person, or his/her luggage or any other property for any reason whatsoever, for any tourist services provided. Personal travel and health insurance is recommended. Secretariat: 9th International Conference - ACC2015 POB 574, Jerusalem 9100402, Israel [email protected] Tel: +972-2-6520574 Fax: +972-2-6520558 13 Conference Registration Registration: Registration fee includes participation in all scientific sessions, program and abstract book, lunches, coffee breaks, get-together reception (Jan.18) and tour and festive dinner (Jan.19). On-line registration will be available until Wednesday, Jan. 14, 2015. Thereafter please register at the registration desk at the conference venue. Registration Fee Standard fee One day price* Nurse, technician, student** Until 15/12/14 $715 $550 $465 Until 14/1/15 $795 $600 $545 On-site $845 $640 $595 * Includes get-together reception (January 18) ** Students must provide proof of registration as full time students for 2014 For online registration, see www.acute-cardiac-care.com Payment: Payment should be made by one of the following methods: • By check made payable to “ISAS International Seminars” • By credit card via the Conference website. • By bank transfer to ISAS International Seminars Ltd. Bank Leumi Branch #780, 19 King David St., Jerusalem, Israel Account Number 9400/87 SWIFT Account: LUMIILIT IBAN Code: IL 690107800000000940087 Bank charges are the responsibility of the participant and must be paid at source in addition to the registration fees. Please make sure the name of the conference and of each participant are indicated on the bank transfer and that fully completed registration forms are submitted together with a copy of the bank transfer. Cancellation Policy: All cancellations must be received in writing, via fax, email or post. Registration cancellations received before December 10, 2014 - full refund less $70 Cancellations received after December 10, 2014 - 50% refund. No refund on cancellations received after January 10. Refunds will be processed within two months after the conference. 14 Accommodations and Tours Organized by Eshet Incoming Accommodations: Rooms are available at the following Tel Aviv hotels: • David InterContinental (Conference Venue) • Dan Panorama • Metropolitan Hotel • Mercure • Ruth Daniel Residence Tours Jerusalem Masada & Dead Sea Biblical Highlights in Nazereth and North / Western Coast Heritage Tours / Bethlehem & Jericho For details and registration: www.acute-cardiac-care.com/hotels-tours E-mail:[email protected] 15 Registration Form – ACC 2015 To register online see: www.acute-cardiac-care.com Please type or print in block letters and return to Secretariat: 9th International Conference ACC2015, POB 574, Jerusalem 9100402, Israel Tel: +972-2-6520574, Fax: +972-2-6520558, email: [email protected] Surname First Name ---------------------------------------------------------------------------------------------------------------------------------------Place of Work ---------------------------------------------------------------------------------------------------------------------------------------email ---------------------------------------------------------------------------------------------------------------------------------------Full Mailing Address Home Work ------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- City, State Country Postal Code ---------------------------------------------------------------------------------------------------------------------------------------Phone Fax ---------------------------------------------------------------------------------------------------------------------------------------- Registration (Standard registration fee includes both dinners) Reception - additional -------- seats Tour and Festive Dinner - additional $ --------------------- $ ---------------------------- seats $ --------------------- Total Payment Instructions Enclosed is check payable to ISAS International Seminars. Charge my credit card: VISA DINERS M/C AMEX $ --------------------- Number ---------------------------------------------------------------------------------------------------------------------------------------- Expiration 3-4 Digit Security Code ---------------------------------------------------------------------------------------------------------------------------------------- Bank transfer to: ISAS International Seminars Ltd. Bank Leumi Branch #780, 19 King David St., Jerusalem, Israel Account Number 9400/87 SWIFT Account: LUMIILIT IBAN Code: IL 690107800000000940087 Please send a copy of bank transfer to [email protected] or +972-2-6520558 Name Signature Date ---------------------------------------------------------------------------------------------------------------------------------------- S p o n s o r s S p o n s o r s