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If it is necessary to change any information after submission, please e-mail the changes to the Symposium Secretariat: mdoprague2024@cbttravel.cz
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I. Personal Details

Title, Given Name

Surname, Title

Institution

Department

Address

City

ZIP Code

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

Telephone+ (+420 123456789)

E-mail

II. Hotel booking

Date of arrival (dd.mm.yyyy)

Date of departure

Number of nights

The following prices of accommodation are always per 1 room and 1 night, and include breakfast service, 12% VAT and city tax.

III. Payment

• Credit Card – Push payment system

  Congress Business Travel will generate a link for you, which will be sent to your email address to provide the payment within 5 working days. This link is valid for several days according to the date indicated in the link. When you receive the link, your browser will be redirected to the payment gateway Global Payment webpay. There, you can pay the same way as when paying in the e-shop.

  The Global Payment Europe - is one of the most used in the Czech Republic with 3D Secure security and can accept payments issued by Visa, Mastercard, Dinners Club.

•  Bank transfer

  Bank name	Ceska sporitelna
  Bank address	Vaclavske namesti 16, Prague 1, Czech Republic, 110 00
  Account number	1942073339
  Bank code	0800
  Account name	Congress Business Travel
  IBAN No.	CZ63 0800 0000 0019 4207 3339
  SWIFT/BIC	GIBA CZ PX
  Payment details	participant's full name / 904 (e.g. John Smith/903) (if it is impossible to include the name on the bank transfer kindly mark "904" only)

V. Notes

Please add any information you regard as important

VI. 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 conference; giving consent is a necessary condition of your registration.