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REGISTRATION FORM

 

Please fill in the form below (all mandatory fields are marked with *)
For the accompanying persons (if any) you can either fill in a separate form (if you wish to get a separate invoice for payment), or fill in the appropriate fields in your form (then you will get a single combined invoice for all fees)
Fields marked with an asterisk are required.

Title/Salutation*:
First name*:
Other names:
Surname/Family name*:
Preffered name for badge*:
Company / Institute:
Address:
Postcode/Zip:
City*:
Country*:
Phone (with country code):
Fax:
E-mail*:
Check if applicable:
I am a student or PhD student (valid student ID card or supervisors recommendation letter may be requested at the registration)



Registration fees (Please tick the appropriate box(es))

Category of participant Early registration (before March 1, 2014) Late registration (after March 1, 2014) On-site registration
Regular participant 450 500 550
PhD student 250 280 330
Accompanying person 190 220 270

Accommodation
Type of room1
Single Standard 270 (for 4 nights)
Twin Standard (shared with another participant) 190 (for 4 nights / per 1 person)
Double Standard 380 (for 4 nights / per 1 room)
I dont need an accommodation at the Conference hotel 0

1 Please note that there is a limited number of rooms of other types, like family 3-room apartment, luxury room with a fire-place etc. Please consult the website of the hotel, http:// book.bestwestern.com/bestwestern/RU/Moscow-hotels/BEST-WESTERN-Country-ResortHotel/Hotel-Overview.do?propertyCode=91205
Those wishing other than a standard type of accommodation please apply to the Conference secretariat by E-mail surforc@phyche.ac.ru or write your requirements in the Comment box below.
Total payment due:
.

Accompanying person:
Title/Salutation*:
First name*:
Surname/Family name*:
Preffered name for badge*:

I wish to share a room with:
My accompanying person
Other participant (please specify in the comment box)
2If you wish to have 2 or more accompanying persons, please provide the names in the Comment box


Comments or special requirements (please type in the text-box):