APPLICATION FOR PARTICIPANTS – NON ICOM MEMBERS - ICOM-CECA 2024 Annual Conference

APPLICATION FOR PARTICIPANTS – NON ICOM MEMBERS

Title

Do you have a PhD (Dr)?

First name

Last name

Institution

0-300

Academic background

0-100

Position in institution

0-300

Street / Number

City / Town

Zip / postal code

Country

Phone number (including country / area code)

Mobile phone reachable during the conference (including country / area code)

E-mail Address

Repeat E-mail Address

Password

Confirm password

Password should:
be at least 6 characters in length , contain at least one lowercase letter , contain at least one uppercase letter

Will you join the optional day trip on Friday 22/11 (extra charge 30 euros – limited seats available)?

Suffering from allergies?

Please Specify

0-150

Other medical requirements?

Please Specify

0-150

Billing Address

Invoice

Company V.A.T.

Company Tax Authority

Company Name

Company Sector

Company Telephone

Company Address

Please remember that your registration is valid, only after your payment is received. The payment date determines the fee.

We remind you that the deadline for the Early bird registration(300 €) is on the 31st of August. The deadline for the Normal registration (350 €) is on the 31st of October. Registration in November costs 400 €.

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APPLICATION FOR PARTICIPANTS – NON ICOM MEMBERS

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