Registration form 

                                                                DEADLINE: May 20th, 2004

 

Mrs/Miss/Mr ________________________________________________________________________________________

                                     Name                                    Family Name                           

 

University degree (subject)               MSc                  PhD                  Postgraduate student   

                             

  __________________________________________________________________________________________________

Institution

 

 __________________________________________________________________________________________________

Mailing address of the institution                  Postal code - City                         Country

 

  __________________________________________________________________________________________________

Telephone                                  Fax                                                       E-mail

 

I wish to attend  the  training session  No.  ________

 

                                                    Payment order

 

Account name: Kongres d.o.o., cesta Dolomitskega odreda 44, 1000 Ljubljana                                                                      
Foreign participants 400 EURO                     Domestic participants   95.000 SIT

                     ¡                                                                         ¡                                                   

Account No.: 02053-0012745211                    Account No.: 02053-0012745211

IBAN: SI56020530012745211                         Notification: 00 117-04                        

Swift Code: LJ BASI2X

Bank Name: NOVA LB d.d.                             Bank Name: NOVA LB d.d.                                

Notification: ZTM 2004

 

I am authorising Kongres d.o.o. to charge  my credit card for the amount covering my

 

registration fee: Visa         Eurocard/Mastercard    

 

Credit Card No. ________________________           Controll  No._____________________

 

Expiry date____________Credit Card Holder _____________________________________

                                           (as written on the card)

 

                                Hotel Reservation

 

For the following nights :                                                                    
                                                           M-HOTEL   single room 70 EUR
 Saturday June 5th 2004                M-HOTEL  double room 50 eur
 Sunday  June 6th 2004                     (transportation  by bus organised)
 Monday June 7th 2004
 Tuesday June 8th 2004                PARK HOTEL  single room 49 eur
Wednesday June 9th 2004            PARK HOTEL double room 32 eur
                                                             
(within walking distance to the lectures)

 

 

___________________                          _________________________________

            Date                                                                   Signature    

 

 

 

                                                                           

 

TO BE SENT BY MAIL TO THE FOLLOWING ADDRESS:

KONGRES d.o.o.,   Dolomitskega odreda 44 
1000 LJUBLJANA, SLOVENIA