FIBRE CONCRETE Registration Form

Surname:

First Name:

Your academic title:

Institution/Affiliation:

Mailing Address:

Post Code:

Town:

Country:

I require invoice (confirming by inserting my VAT number):

Invoicing Address (if different from Mailing Address):

Phone:

E-mail:

REGISTRATION FEE - SELECT PROPER OPTION(S):

Participant
early (until June 30): 290 EUR / late (after June 30): 350 EUR
EUR (please fill in the amount):

Invited / Honorary Guest / Organizer
free of charge
EUR (please fill in the amount):

Additional paper
50 EUR
EUR (please fill in the amount):

I WILL ATTEND THE FOLLOWING SOCIAL EVENTS:

Welcome drink (September 17) - included in the registration fee:
YES NO

Conference dinner (September 18) - included in the registration fee:
YES NO

Excursion (September 19) - 10 EUR:
YES NO

FOR ACCOMPANYING PERSON I WISH TO ORDER THE TICKET FOR THE FOLLOWING SOCIAL EVENTS:

Conference dinner (September 18) - until June 30 / after June 30 - 70 / 80 EUR
No. of tickets:

Excursion (September 19) - 10 EUR:
No. of tickets:

TOTAL PAYMENT:

By CREDIT CARD. Please fill in the sum of all applicable fees ( EUR ). After submitting you will be forwarded to the payment gateway of our bank:

By BANK TRANSFER. Please fill in the sum of all applicable fees ( EUR ):

Bank account No.: 176970780/0300 of the Conference Partners Prague Ltd.,
at the Československá obchodní banka, a. s., Anglická 20, 120 00 Prague 2, Czech Republic.
IBAN: CZ64 0300 0000 0001 7697 0780, BIC (SWIFT code): CEKOCZPP

Be so kind and send the scan of the bank transfer confirmation by email to: FC2019@conferencepartners.cz.

By submitting this form you give us a consent for processing your personal data connected to your participation at the FC 2019 in accordance with the European General Data Protection Regulation (EU GDPR) entered into force as of 25 May 2018.

10th International Conference FIBRE CONCRETE 2019

September 17-20, 2019 – Prague, Czech Republic

Registration Form

REGISTRATION FEE - SELECT PROPER OPTION(S):

I WILL ATTEND THE FOLLOWING SOCIAL EVENTS:

FOR ACCOMPANYING PERSON I WISH TO ORDER THE TICKET FOR THE FOLLOWING SOCIAL EVENTS:

TOTAL PAYMENT: