Registration

1. Personal information

First name:*
Surname:*
Sex:*

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

type:
Email:*
Address:*
Postal Code:*
Country:*
Province:*
City:*
Phone:*
Phone 2:
Nationality:

University, Institution or Organization:
Department / Area / Job:
Additional information
I would like to register to the Mini-colloquium on June 21st (free):*

Yes
No thank you
Please inform if you have any dietary requests:*

2. Registration type

Mark your category:

Regular: 390.00 €

Student: 290.00 €

Students in BAYFLEX laboratories: 180.00 €

Free registration for Invited Speakers

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

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