Registration

Arrival Information
Salutation: *	Mr. Mrs. Miss
Degree or title: *	Prof. Ph.D. M.Sc. Eng.
First name: *
Family name: *
Institution and affilations: *
Postal address (street, ZIP, City): *
Country: *
Phone: *
E-mail: *
Accompanying person (first name, family name): (optional)
The Registration includes: Conference kit with conference program, book of abstracts, Conference proceedings CD and Conference badge Coffee-breaks Coctail and gala dinner %23 VAT
I would like to participate in:	gala dinner tour around Lodz
the cost of gala dinner and the tour are included in conference fee Registration Cancellation & Return Terms* The fee will be refunded for cancellations reported until the March 15th, 2015 %50 of the fee will be refunded for cancellations reported until the March 29th, 2015 Cancellations after the March 29, 2015 will not be refunded, name changes will be accepted
Arrival date:
Departure date:
Information required on an invoice.
Company name: *
Address: *
VAT number: *
Participant(s) name(s) and price(s): *
Other informations: (optional)
Corespondence address (if different than address on an invoice): (optional)