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Title:  *
Last Name:  *, **
First Name:  *, **
Gender: *
Institution:  *
Department:  *
Address:  *
Post Code/City:  *
Country:  *
Phone (mobile if possible): *
Fax:
e-mail (must be valid a address): *, **

In the Conference – School I would like to present:

  oral presentation (invited lecture), *

  poster presentation. * Topic

Presentation title:

Co-authors of presentation:

Accompanying person *

Information about accompanying persons (first name and last name):

Please book the Guest House “Politechnika” *

I will book the hotel on my own *

More information about accommodation

I agree that all information is correct  *

 

* Compulsory fields;
** Fields that will be used for the abstract upload.