| Please use capital letters and indicate below by crossing the appropriate field. |
| Degree: |
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| Last Name: |
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| First Name: |
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| Company / Institution: |
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| Street, No.: |
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| City; ZIP code: |
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| Country: |
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| E-mail: |
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| Company ID (IČ): |
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| VAT No. (DIČ): |
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| PRESENTATION |
| Title of presentation: |
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| Form of presentation: |
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| Title of second presentation: |
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| Select a topic: |
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| Conference paper: |
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| Registration fee: |
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| *Date of One-Day Fee: |
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| Confirmation of study: |
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| ACCOMMODATION |
| Accommodation: |
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| Room: |
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| Dates of accommodation: |
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| **The price in Hotel Garni includes: one night's accommodation and breakfast. Payment of accommodation: cash in Czech crowns or card at hotel reception.
Another type of accommodation is provided by the participant himself. |
| Accomodation: |
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| Please answer numerically: |
Sum of dvacetjedna and sedmnáct
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Odesláním formuláře prohlašuji, že beru na vědomí zpracování osobních údajů
(informační povinnost vůči objednateli v souladu s Nařízením Evropského parlamentu a Rady 2016/679 o ochraně fyzických osob).
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