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First name* |
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Surname* |
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Email* |
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E - m a i l * |
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E - m a i l (optional) |
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Affiliation: | |
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University/Institution |
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Phone* |
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Department/Faculty |
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Institute |
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City |
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| Country |
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Participation: | |
| Participation in the conference |
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| Arrival date | |
| Departure date | |
| I will give a talk | (select for "yes") |
| Title of the talk | |
Accompanying persons: | |
| The number of accompanying persons |
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TAX invoice:
(please fill every field if the invoice is to be issued to a institution,
for invoices issued to a person please contact the organizers) | |
| I need a tax invoice for the payment | (select for "yes") |
| TAX Number (NIP) | |
| Invoice receiver (bill to) | |
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| Invoice receiver address |
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| Please send invoice to the following address |
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Other | |
| Conference excursion to Wieliczka Salt Mine |
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Remarks
Please notify us if you have special
diet preferences (vegetarian, etc.) |
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I hereby agree for my personal data, included in this registration form, to be processed in line with the needs of
the conference.
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