Registration_online | ESAS

ONLINE REGISTRATION FORM

The items marked with an asterisk (*) are required.

PERSONAL INFORMATION

Title

Prof

Name *

Surname *

Institution *

Country *

Email *

Telephone *

PARTICIPATION INFORMATION

Registration fee *

Participant - Member of IMMSS or SSS (600 € / 15 000 CZK)

Participant - Non-member of IMMSS or SSS (750 € / 19 000 CZK)

Student (470 € / 11 900 CZK)°

Accompanying person (300 € / 7 600 CZK)

Invited speaker

Exhibitor

Organizer

1-day registration (180 € / 4 500 CZK)

The fees include VAT. Registration fees are valid for early registration before April 30, 2022. ° ISIC or other document for student fee download at the end of registration form.

Presentation *

Yes

Presentation type

Lecture - invited speaker

Lecture

Poster

If you plan present more than one poster, please, write the note to information for organizers at the end of this form.

Preliminary title

Payment *

No payment

Bank transfer

Credit card°

° The credit card processing fee is 3%; the link to make the payment will be sent via email after checking the registration.

Invoicing *

No invoicing

Wait for the order to arrive

Issue invoice without an order

I plan to attend social programme

Welcome party (Sunday, September 4)

Evening with the stars and planets (Monday, September 5)

Excursion (Wednesday, September 7)

Conference dinner (Thursday, September 8)

INVOICING INFORMATION

Invoicing address

ID number (IČO)

VAT ID number (DIČ)

Please, make sure that the Invoice address, ID number and VAT ID number are filled correctly.

Download ISIC / student confirmation

Files must be less than 2 MB.
Allowed file types: jpg jpeg png pdf doc docx odt.

You can leave us a message

Please fill in the registration form carefully and check it before submitting.

If you want to change the already sent registration, contact us at spmirka@centrum.cz; please do not fill out a new registration.