On-line Registration - step 1 Please check the contents of this form carefully. If it is necessary to change any information after submission, please e-mail the changes to the Conference Secretariat: conference.pacw@cbttravel.cz For your convenience, the system will remember your personal data and use it in any other forms you submit. The system will forget your data if you close this window or stay on this page for more than 30 minutes without submitting. By registering for the PAC World Conference, the participant understands that any photos, videos, etc. may be shared within our social media, other participants, or for marketing efforts. = required field(s) I. Personal details First Name Last Name Company Job title Address City StateCountrySelect 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 ArabiaSenegalSeychellesSierra LeoneSingaporeSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSpainSri LankaSudanSurinameSwazilandSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTogoTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVaticanVenezuelaVietnamPalestineWestern SamoaWestern SaharaYemenYugoslaviaZambiaZimbabwe ZIP Code Phone+ (+420 123456789) E-mail Can we share your email and details with the vendors? Yes No Do you need an original invoice copy? Yes No Do you need a VISA letter? Name on passport Passport number 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 SaharaYemenYugoslaviaZambiaZimbabwe Yes No II. Registration fees All amounts are shown with the 21% VAT included. Registration fee Payment Registration Early Registration (In-Person)– before May 30th599 EUR EUR Early Virtual Registration (Online)– before May 30th273 EUR EUR Author478 EUR EUR Student260 EUR EUR Standard Registration (In-Person)– starting June 1st720 EUR EUR Standard Virtual Registration (Online)– starting June 1st333 EUR EUR 1-day Full Conference pass including conference session: June 21, 2022357 EUR EURJune 22, 2022357 EUR EURJune 23, 2022357 EUR EUR 1-day Exhibition Area Only/Guest Pass with no conference session: June 21, 202248 EUR EURJune 22, 202248 EUR EURJune 23, 202248 EUR EUR Additional Options: Welcome Reception – Monday, June 20th at 6 pmFree EURTutorial – Monday, June 20th at 2 pm103 EUR EURTechnical visit – Friday, June 24th (done by 1 pm)36 EUR EUR Gala Dinner - Wednesday, June 22 at 6 pm Meat (Beef or Chicken, tbd.) Vegetarian61 EUR EUR pers. × 61 EUR Spouse fee (includes the Welcome Reception and Gala Dinner) Meat (Beef or Chicken, tbd.) Vegetarian61 EUR EUR pers. × 61 EUR Total EUR Key Notes: All Registrations, except the 1-day guest passes, are invited to join us for the Welcome Reception on June 20th. Those attending the conference sessions must sign in each day to receive credit for their certificate. Lunch and Break Refreshments will be provided to all conference and exhibition attendees during each conference day. (Tuesday – Thursday) Tax invoices: All amounts are shown with the 21% VAT included. III. Payment Credit Card I authorize Congress Business Travel Ltd. (Lidická 43/66, 150 00 Prague 5, Czech Republic, VAT number: CZ26424053)to charge my credit card for the payment of EURAccording to the Czech law, credit cards will be charged in local currency / Czech Crowns (CZK)according to the actual exchange rate of the Czech National Bank.Type of cardSelectAmerican ExpressVISAMasterCard/EuroCardDinersName of card holderCard numberExpiration date (mm/yy)CVV/CVC (last 3 digits)*Invoice address (AMEX)*) CVC2 (MasterCard/EuroCard) or CVV2 (American Express, Visa) code is printed on the back side of your credit card in the signature label (last 3 digits). Bank Transfer Bank nameCeská sporitelna Bank addressRytířská 29, 110 00 Praha 1 Account number1942073339 Bank code0800 Account nameCongress Business Travel IBANCZ63 0800 0000 0019 4207 3339 SWIFT / BICGIBA CZ PX Payment details Conference variable symbol: 706 + participant´s name (706 John Smith) Please note that any bank fees charged for the bank transfer should be fully covered by the participant. A copy of the bank transfer sheet should be sent by fax or mail to the Conference Secretariat – fax: +420 224 942 550, e-mail: conference.pacw@cbttravel.cz. All registration payments are due before the conference start. IV. Payer I request a proforma invoice on my name Different payer or invoiceOrganization name Invoice addressMailing Address City State 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 ArabiaSenegalSeychellesSierra LeoneSingaporeSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSpainSri LankaSudanSurinameSwazilandSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTogoTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVaticanVenezuelaVietnamPalestineWestern SamoaWestern SaharaYemenYugoslaviaZambiaZimbabwe Contact personTelephone+ (+420 123456789) E-mailVAT V. Notes 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. VII. Cancellations and refunds The Organizing Secretariat must be notified in writing by e-mail to conference.pacw@cbttravel.cz or fax (+420 224 942 550) about the cancellation of the registration. Telephone cancellation will not be accepted. The appropriate refunds will be made after the Congress. The following cancellation conditions apply: Any cancellations after May 25th have a 20% cancellation fee, no refunds after June 8th.