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Registration form

Please complete all relevant fields.
Fields underlined are obligatory.


:.  Contact Information

First Name:  
 
 
Last Name :  
(Family Name)
 
 
Affiliation:  
 
 
E-mail:  
 
 
Postal address:  



:.  Your Presentation

Title of Presentation:


:.  Arrival and Departure

Arrival and Departure Date (if different from 26th September and 30th September):

Arrival: 
 
 
Departure: 

:.  Additional information

Please specify any special needs or requests (diet, etc.):



Conference fee: 400 PLN / 100 EUR
The deadline for making your full payment is to be announced.

The fee should be paid via bank transfer:

Bank Pekao S.A.

Account holder: KONTO WYDZIALOWE WFAIS
Address: ul. Reymonta 4, 30-059 Krakow

IBAN code: PL59 1060 0076 0000 3210 0002 3180
SWIFT CODE: PKOPPLPW

with reference to: "23MSS"



That is all! Please check the above input data carefully once again then press the Submit button below:

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