On-line Registration – step 1

Please check the contents of this form carefully as you will not be able to make modifications after submission. If it is necessary to change any information after submission, please e-mail the changes to the Congress Secretariat: eflmprague2026@cbttravel.cz
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I. Personal details

Surname

Name(s)

Title (as requested)

Institution

Department

Address

City

CountrySelect countryAfghanistanAlbaniaAlgeriaAndorraAngolaAntigua-BarbudaArgentinaArmeniaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBhutanBoliviaBosnia-HerzegovinaBotswanaBrazilBruneiBulgariaBurkina FasoBurma (Myanmar)BurundiCambodiaCameroonCanadaCape VerdeCentral African RepublicChadChechnyaChileChinaColombiaComorosCongo, RepublicCongo, Democratic Rep.Costa RicaCote d IvoireCroatiaCubaCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEast TimorEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFijiFinlandFranceFrench GuianaGabonGambiaGeorgiaGermanyGhanaGreeceGreenlandGrenadaGuatemalaGuineaGuinea-BissauGuyanaHaitiHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyJamaicaJapanJordanKazakhstanKenyaKiribatiKorea, NorthKorea, SouthKosovoKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMauritaniaMauritiusMexicoMicronesiaMoldovaMonacoMongoliaMoroccoMozambiqueNamibiaNauruNepalNetherlandsNew ZealandNicaraguaNigerNigeriaNorwayOmanPakistanPalauPanamaPapua New GuineaParaguayPeruPhilippinesPolandPortugalQatarRomaniaRussiaRwandaSaint Kitts and NevisSaint LuciaSaint Vincent-GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSpainSri LankaSudanSurinameSwazilandSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTogoTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVaticanVenezuelaVietnamPalestineWestern SamoaWestern SaharaYemenZambiaZimbabwe

ZIP code

Phone+ (+420 123456789)

E-mail

II. Registration fees

	Early fee until January 31, 2026	Late fee from February 1, 2026	payment
EFLM Academy Members
Regular fee	280  EUR	320  EUR	EUR
Young Registration (under 35 years)	120  EUR	150  EUR	EUR
Non EFLM Academy Members
Regular fee	380  EUR	420  EUR	EUR
Young Registration (under 35 years)	170  EUR	190  EUR	EUR
Virtual attendance
Virtual attendance fee	170  EUR	170  EUR	EUR

The virtual attendance fee includes:

• access to all live sessions and conference materials

III. Dietary Requirements:

Lactose free

Gluten free

Vegetarian

Vegan

IV. Payment

• Credit Card – Push payment system

  Congress Business Travel will generate a unique payment link for each participant, which will be sent to their email address within 5 business days.

  The link will remain valid for a few days, as indicated in the email. If you choose to pay via PUSH payment, simply click on the link, and your browser will redirect you to the GPwebpay payment gateway.

  GPwebpay – Global Payments Europe is one of the most widely used payment gateways in the Czech Republic. It is secured with 3D Secure and supports payments from Visa, Mastercard, Eurocard.

• Bank Transfer

  Bank name	Česká spořitelna
  Bank address	Rytířská 29, 110 00 Praha 1, Česká republika
  Account number	1942073339
  Bank code	0800
  Account name	Congress Business Travel
  IBAN	CZ63 0800 0000 0019 4207 3339
  SWIFT / BIC	GIBA CZ PX
  Payment details	participant's full name / 204 (e.g. John Smith / 204) (if it is impossible to include the name on the bank transfer kindly mark "204" only)

  Please note that all bank charges should be fully covered by the payer.
  The copy of the bank transfer should be sent by fax or mail to the Conference Secretariat.

VI. Notes

Please write your requirements (not guaranteed)

VII. I agree with the use of my personal data

I agree with the use of my personal data by the company Congress Business Travel spol., s r.o., in accordance with the Czech Personal Information Protection Act 101/2000 Sb. The data will be used solely for the purposes of this symposium; giving consent is a necessary condition of your registration.