Neutrino Geoscience 2019 | Registration Form

PERSONAL DATA

First name (required)

Surname (required)

Institution (required)

Address

City

Potal code / ZIP

E-mail (required)

REGISTRATION DATA

Fee

Participant

Regular fee
Student fee

Registration fee due CZK (= EUR)

Note

Regular & Student fee includes: access to all conference sessions, conference materials, coffee breaks and catered lunches (VAT included).

SOCIAL PROGRAM

Conference dinner

Quantity:

Total CZK (= EUR)

OPTIONAL

Do you intend to present? (required)

YES
NO

Presentation title

Presentation type preference

TALK
POSTER

ACCOMMODATION

Kapacita ubytování již byla naplněna.

Date of arrival . 2019

Date of departure . 2019

Nights total

Total CZK (= EUR)

The room price includes one night in a single or double room, and breakfast. (Price includes VAT.)
Room reservations cannot be made without advance payment. The hotel voucher will be mailed to you upon receipt of payment.

CANCELLATION POLICY
Cancellation	before Jun 1, 2019	from Jun 1 through Oct 4, 2019	after Oct 4, 2019
Registration	--	50%	N.A.

Cancellation request will be accepted only by e-mail, fax or mail sent to the address of the AMCA Agency (see the bottom of this page) with a reference to your registration ID.

PAYMENT

By credit card

Internet payment may be made after submitting your registration.
On-line credit card payments over the internet are secured by 3D SECURE.

26.22 CZK / 1 EUR

Direct Bank Transfer

Bank: Fio banka, a.s., V Celnici 10, 117 21 Prague 1, Czech Republic
Account Name: AMCA, spol. s r.o.
Account Number: 2001055491/2010
IBAN: CZ37 2010 0000 0020 0105 5491
BIC: FIOBCZPPXXX
Details of payment: Please enter the registration number you will receive in the e-mail confirmation of your registration
N.B. Please note that all direct bank transfer charges must be covered by the participant. Please forward a copy of your bank transfer order to the address of the secretariat.

Total due0 CZK (= EUR)

ANTISPAM PROTECTION

Type only the black letters below.

I agree to data processing principles of the conference Neutrino Geoscience 2019.
Data processing principles can be found here. (required)