Registration

Presenting author's personal details:

Title:
* First name(s):
* Family name:
* Sex:
Nationality / Citizenship:

Address:

Department:
Institute/University/Department:
Street, No.:
Postal (ZIP) code:
City:
Country:
* Phone No.:
* Fax No.:
* VAT No.:
* E-mail:

Please register me for the Symposium as participant.
Registration fees in Euro (€) (tick required)

participiant / registration fee - before May 31,2010 - €350
participiant / registration fee - after May 31,2010 - €400
student / registration fee - before May 31,2010 - €200
student / registration fee - after May 31,2010 - €250
accompanying person - per person €50 - number of people

The fees do not include any kind of insurance. The Organizing Comittee and the Symposium Secretariat do not accept liability for personal accidents, losses or domage.

Health, baggage or accident insurance is recommended and must be taken out in your own country.

Presentation registration

I wish to:

apply for oral presentation / number of present poster(s)
I am invited speaker

Presentation 1.

Type:
Topic:
Title:
Author(s):
Affilations(s):

Presentation 2.

Type:
Topic:
Title:
Author(s):
Affilations(s):

Presentation 3.

Type:
Topic:
Title:
Author(s):
Affilations(s):
Billing address:

Please enter correct information for make the bill/invoice for payment: name of the company/institute, full address (and EU VAT ID number of your company/institite - only for EU member countries)

Cancellation and refund

Cancellation of participation must be sent in writing to the Symposium Sectretariat (fusarium2010@ihar.edu.pl) before August 1, 2010 for a full refund less bank charges EUR 50. No refunds are available after August 20, 2010.

Methods of payment

Please pay the registration fee(s) in Euro(€) not later than 30.06.2010 using one of the following methods of payment:

Bank transfer to:

- PEKAO SA I Oddzial w Bloniu, Poznanska 4, 05-870 Blonie, Poland
- SWIFT / BIC: PKOPPLPW
- Beneficiary: Instytut Hodowli i Aklimatyzacji Roslin, Radzikow, 05-870 Blonie, NIP: PL 529-000-70-29
- Account No. (IBAN): PL 54 1240 2164 1111 0000 3561 7204
- Note, remark: Fusarium 2010 + name of participant(s)

Bank cheque: (Personal cheques cannot be accepted.)

- payable to "Fusarium2010" and send to postal address: Instytut Hodowli i Aklimatyzacji Roslin, Radzikow, 05-870 Blonie, Poland

Note, requests: