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47. SLÉVÁRENSKÉ DNY
  

BINDING APPLICATION FORM

7thInternational PhD Foundry Conference


Name
Surname
Degree
Name of Institute
Street
ZIP code
City
Country
VAT no
Phone
Fax:
E-mail:
Title of paper/poster
Authors
Conference fee € 60 /CZK 1600


Accommodation

Date of arrival: 22.6.2010
23.6.2010
Date of departure: 24.6.2010
25.6.2010
Binding booking of accommodation:
* Student Hotel Palacký,
Kolejní 2, Brno
single room
€ 40/CZK 1 000 /person/night
double room
€ 55/CZK 1 300 /2 persons/night
* Hotel Continental,
Kounicova 6, Brno
single room
€ 55/CZK 1 300 /person/night
double room
€ 70/CZK 1 800 /2 persons/night
Common room with


Payment method

Payment method Payment by Bank transfer
Payment by Credit card
Credit card details Eurocard / Mastercard
Visa
Cardholder's name:
Card Number:
Expiration Date:
CVV2 Code: