Registration Form

 
    Personal data
Family Name Title(s)
First Name    
 
Institute VAT No.
Street and No.
City ZIP
 
Country
 
E-mail Phone
 
    Participation
In the Geo3M day only (free of charge)
In the Geo3M day and Colloquium
 
    Conference contribution
Form of contribution:             Oral             Poster             None
Please complete: a title of contribution, authors, key words (3-5), annotation (max. 100 words).
 
    Accomodation requests
    The conference fee covers only the accomodation on June 25-26, 2014.
    In addition to that, I ask for the accomodation also on:
 
June 23, 2014 (Ostrava)   June 24, 2014 (Ostrava)   June 27, 2014 (Mountain Hotel Solan)
 
    (Hotels and prices are available upon request)
 
    I prefer the accomodation in:
 
Single room
Double room shared with
 
    Notes, remarks
 
    For the easier identification of your payment, the system will generate unique digits that will be assigned to you.
    Please use them at the payment as Details of payment.