Personal information
Title (degree):
First name:*
Last name:*
Gender:
female
male
Organization:*
Address #1:
Address #2:
City:
State/Province/Region:
Zip/Postal Code:
Country:*
select country
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antigua and Barbuda
Argentina
Armenia
Aruba
Ashmore and Cartier Islands
Australia
Austria
Azerbaijan
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Bahrain
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Belgium
Belize
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Botswana
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Chile
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Christmas Island
Coco (Keeling) Islands
Colombia
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Congo, Republic of
Cook Islands
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Guinea-Bissau
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Iraq
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Madagascar
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Mali
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Netherlands Antilles
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Nigeria
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Northern Mariana Islands
Norway
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Palau
Panama
Papua New Guinea
Paraguay
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Pitcairn Islands
Poland
Portugal
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Reunion
Romania
Russia
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Saint Lucia
Saint Pierre and Miquelon
Saint Vincent and Grenadines
Samoa
Saudi Arabia
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Serbia
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Sierra Leone
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Slovenia
Solomon Islands
Somalia
South Africa
South Korea
Spain
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Sudan
Surinam
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Switzerland
Syria
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Tajikistan
Tanzania
Thailand
Togo
Tokelau
Tonga
Trinidad & Tobago
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States of America
Uruguay
Uzbekistan
Vanuatu
Vatican City (Holy See)
Venezuela
Vietnam
Virgin Islands
Wallis and Futuna
West Bank
Western Sahara
Yemen
Zaire
Zambia
Zimbabwe
Phone:
Fax:
E-mail:*
Information to be placed on an invoice
Organization:
Address #1:
Address #2:
City:
Zip/Postal Code:
Country:
select country
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antigua and Barbuda
Argentina
Armenia
Aruba
Ashmore and Cartier Islands
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
British Indian Ocean Territory
British Virgin Islands
Brunei
Bulgaria
Burkina Faso
Burma
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China (People's Republic)
Christmas Island
Coco (Keeling) Islands
Colombia
Comoro Island
Congo, Democratic Republic of
Congo, Republic of
Cook Islands
Costa Rica
Croatia
Cuba
Cyprus
Czech Republic
Denmark
Djibouti
Dominica
Dominican Republic
East Timor
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Guiana
French Polynesia
Gabon
Gambia
Gaza Strip
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong SAR
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Isle of Man
Israel
Italy
Ivory Coast
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia, Republic of
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mexico
Micronesia, Federated States
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
North Korea
Northern Mariana Islands
Norway
Oman
Pakistan
Palau
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Republic of San Marino
Reunion
Romania
Russia
Rwanda
Saint Kitts and Nevis
Saint Lucia
Saint Pierre and Miquelon
Saint Vincent and Grenadines
Samoa
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
South Korea
Spain
Sri Lanka
Sudan
Surinam
Svalbard
Swaziland
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Togo
Tokelau
Tonga
Trinidad & Tobago
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States of America
Uruguay
Uzbekistan
Vanuatu
Vatican City (Holy See)
Venezuela
Vietnam
Virgin Islands
Wallis and Futuna
West Bank
Western Sahara
Yemen
Zaire
Zambia
Zimbabwe
NIP number (Tax Identification Number):
Registration fees
Prefered form of presentation
P - Poster session
O - Oral presentation
I am:
Additional pages (even number of pages recommended):
x 50 PLN =
PLN
(total amount for all your papers; 8 pages/paper are included in regular/member fee)
I would like to register:
Registration fee:
PLN
Extra Gala Dinner and Welcome Party ticket (e.g. for spouse):
x 400 PLN =
PLN
Please specify your menu preferences:
Pork menu:
Vegetable menu:
Fish menu:
Total number of choices must be equal to the total number of tickets
(remember to count your ticket too)
Extra lunch ticket (e.g. for spouse):
Thursday:
x 50 PLN =
PLN
Friday:
x 50 PLN =
PLN
Saturday:
x 50 PLN =
PLN
TOTAL AMOUNT:
PLN
(Warning! Some banks (on your side) may charge additional processing fees that are subtracted from the amount that you have specified on your wire transfer order. Add them to the total amount due. Only registrations accompanied by an exact sum of money (on our side) will be valid.)
I will pay:
by wire transfer
by credit card (more details )
Additional comments to the Registration Chair
Participants from some countries may need an entry visa for Poland. Among these countries are: Algeria, China, Egypt, India, Iran, Lebanon, Russian Federation, Saudi Arabia, Serbia, Taiwan, Ukraine.
It is recommended to check whether or not an entry visa is required (regulations are changing rapidly).