On-line Registration - step 1
 

Please check the contents of this form carefully as you will not be able to make modifications after submission.
If it is necessary to change any information after submission, please contact the Conference Secretariat.

= required field

1. Personal Data

Title, Given Name

Surname, Title

Affiliation

Address

City

ZIP Code

CountryAfghanistanAlbaniaAlgeriaAndorraAngolaAntigua-BarbudaArgentinaArmeniaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBhutanBoliviaBosnia-HerzegovinaBotswanaBrazilBruneiBulgariaBurkina FasoBurma (Myanmar)BurundiCambodiaCameroonCanadaCape VerdeCentral African RepublicChadChechnyaChileChinaColombiaComorosCongo, RepublicCongo, Democratic Rep.Costa RicaCote d IvoireCroatiaCubaCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEast TimorEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFijiFinlandFranceFrench GuianaGabonGambiaGeorgiaGermanyGhanaGreeceGreenlandGrenadaGuatemalaGuineaGuinea-BissauGuyanaHaitiHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyJamaicaJapanJordanKazakhstanKenyaKiribatiKorea, NorthKorea, SouthKosovoKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMauritaniaMauritiusMexicoMicronesiaMoldovaMonacoMongoliaMoroccoMozambiqueNamibiaNauruNepalNetherlandsNew ZealandNicaraguaNigerNigeriaNorwayOmanPakistanPalauPanamaPapua New GuineaParaguayPeruPhilippinesPolandPortugalQatarRomaniaRussiaRwandaSaint Kitts and NevisSaint LuciaSaint Vincent-GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSpainSri LankaSudanSurinameSwazilandSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTogoTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVaticanVenezuelaVietnamPalestineWestern SamoaWestern SaharaYemenZambiaZimbabwe

Telephone+ (+420 123456789)

E-mail

2. Registration fees

The registration fee covers accommodation in a double room (two nights), buffet meals (2x breakfast, 3x lunch, 2x dinner), refreshment during coffee breaks (4x), the Book of Abstracts and Conference materials. The registration fee can be paid on-line by card or by bank transfer.

3. Dietary Requirements:

Lactose free

Gluten free

Vegetarian

Vegan

4. Accommodation

 I prefer to be accommodated with   

 
Please specify the surname and name of the person with whom you would like to share the double room accommodation.

5. Abstract

Abstract Submission till 15 September.

Notification of the Contribution Acceptance till 18 September.

Please use the template for the preparation of the abstract.

Download an abstract template

I would like to present my contribution as:

short oral communication

poster
 

I would like to apply for The Otakar Cervinka Prize for the best short oral communication / poster
 

Attach abstract:

6. Payment

• Credit Card - Push payment system

  Congress Business Travel will generate a unique payment link for each participant, which will be sent to their email address within 5 business days.

  The link will remain valid for a few days, as indicated in the email. If you choose to pay via PUSH payment, simply click on the link, and your browser will redirect you to the GPwebpay payment gateway.

  GPwebpay - Global Payments Europe is one of the most widely used payment gateways in the Czech Republic. It is secured with 3D Secure and supports payments from Visa, Mastercard, Eurocard.

• Bank Transfer

  Bank name	Ceska sporitelna
  Bank address	Rytirska 29, 110 00 Praha 1, Ceska republika
  Account number	1942073339
  Bank code	0800
  Account name	Congress Business Travel
  IBAN	CZ63 0800 0000 0019 4207 3339
  SWIFT / BIC	GIBA CZ PX
  Payment details	participant's full name / 212 (e.g. John Smith / 212) (if it is impossible to include the name on the bank transfer kindly mark "212" only)

  Please note that all bank charges should be fully covered by the payer.
  The copy of the bank transfer should be sent by mail to the Conference Secretariat.

7. Payer

 I request a proforma invoice

Different payer of invoice

8. Notes

Please write your requirements (not guaranteed)

9. I agree with the use of my personal data

I agree with the use of my personal data by the company Congress Business Travel spol., s r.o., in accordance with the Czech Personal Information Protection Act 101/2000 Sb. The data will be used solely for the purposes of this symposium; giving consent is a necessary condition of your registration.