Registration

1. Personal information

First name:*
Surname:*
2nd surname:
Sex:*

Female Male
Gender:*
Date of birth (DD/MM/YYYY):*
ID number / Passport (12345678X):*

type:
Email:*
Address:*
Postal Code:*
Country:*
Province:*
City:*
Phone:*
Nationality:

University, Institution or Organization:
Department / Area / Job:
Additional information
Do you have any food intolerances/allergies/special meal request?:
For the gala dinner, which main course option do you prefer:*

Meat
Fish
Vegetarian

2. Registration type

Mark your category:

General: 200.00 €

Keynote Speaker
Payment Options:
Pay online by credit card. It sends you to a safe bank payment gateway
Bank transfer. On the next page you will find the necessary information to make the transfer

Billing:

Personal information invoice
University/Company invoice

Invoice data

Company Name:*
Company ID (VAT number):*
Phone:*
Tax adress:*
Postal code:*
Country:
Province:*
City/Town:*
Email:*

I have read and I accept the Personal Data Protection terms and conditions