Registration * Povinné Surname * Fill in your surname Táto otázka je povinná Name * Fill in your name Táto otázka je povinná Address – Street and house number * Fill in the name of the street and house/appartment number Táto otázka je povinná Address - City * Fill in the city of your residence Táto otázka je povinná Address - Postcode * Fill in the postcode of your residence Táto otázka je povinná Country * Fill in the country you come form Táto otázka je povinná E-mail * Fill in the email address you are using regularly Táto otázka je povinná Phone * Fill in the phone number you are using regularly + country code Táto otázka je povinná Type of event * Fill in the type of event or combination of events you would like to attend Image Medicine Conference - price 50 € Image Medicine Seminar - price 50 € Intensive ZYQ practice - price 130 € Conference + IM Seminar - price 220 € Conference + Intensive ZYQ practice - price 170 € Image Medicine Seminar + Intensive ZYQ practice - price 300 € Conference + IM Seminar + Intensive ZYQ practice - price 330 € Táto otázka je povinná Type of participation at the IM Conference Select type of participation Participant without presentation / Visitor Participant with presentation / Speaker Táto otázka je povinná Type of presentation State what type of presentation you would like to give Short 5 to 10 min presentation 20 to 30 min presentation 30 - 90 min workshop Article for publishing in conference journal – without oral presentation Táto otázka je povinná Prostredníctvom Formulárov Google nikdy neodosielajte heslá.
