Pime 2012

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PIME 2012

Warsaw, Poland (2012-02-12 - 2012-02-15)

COMMUNICATING NUCLEAR

Registration form

Grey input fields are mandatory.

Title

Academic degree

First name

Last name

Organisation

Department

Position

Address 1

Address 2

Postal code

City

Country

E-mail

E-mail (Please confirm)

Telephone

Please include country code

Fax

Please include country code

VAT ID Nr

Only if needed for invoice

Purchase Order Nr

Your Purchase Order nr (if applicable, specific to your company that should be included on the invoice that is compulsory for payments)

Address for invoice if different from above, otherwise leave empty

Name 1

Name 2

Address 1

Address 2

Postal code

City

Country

REGISTRATION

The registration includes access to all sessions, conference materials, coffee breaks, lunches, social events and technical visit.

ENS Member 1000 EUR

ENS Members (Applies to members of ENS National Societies, ENS Corporate Members (employees of companies who are Corporate Members) and ENS

ENS Non Member 1100 EUR

Professionals from and working in Eastern European countries 750 EUR

ENS Young Generation Network 500 EUR

ENS Young Generation Member (YGN) (Applies to YGN members of ENS National Societies, i.e. to members younger than 36 years);

INVITATION LETTER

Please fill in the required information for security check and invitation letter below

I need an Invitation Letter

I need an Invitation Letter that shall be send by express delivery (FedEX, DHL) 90 EUR

TECHNICAL TOUR

All available places for the technical tour have been taken. It is currently not possible anymore to register for the technical tour. Wednesday 15 Feburary 2012 to the National Centre for Nuclear Research - with research reactor MARIA. For participants only

No, I will not participate

I will participant at Technical Visit to the Andrzej Soltan Institute of Nuclear Studies and to POLATOM

INFORMATION FOR SECURITY CHECK AND INVITATION LETTER

Only required for participants of the Technical Tours or if you require an Invitation Letter

Nationality:

Place of Birth:

Date of Birth:

Home address:

Home town:

Passport / ID nbr:

Passport/ID issue date:

Passport/ID expiry date:

CONFERENCE DINNER

Monday 13 February 2012

I will attend at the Conference Dinner

Accompanying guest for Conference Dinner 75 EUR

Name of accompanying guest

Accompanying second guest for Conference Dinner 75 EUR

Name of second guest:

I'm vegetarian

Accompanying guest is vegetarian

Accompanying second guest is vegetarian

Payment

Please select your preferred payment method

Online Payment (Ogone) - Only Visa and Eurocard/Mastercard accepted

Payment by bank transfer

By clicking the button 'OK' the total amount of your registration fee will be calculated and all selected options can be validated.

Cancellation policy

Cancellations must be communicated in writing. There will be no refund if cancellations are made after 12 January 2012 (one month prior). For cancellations prior to 13 January 2012, an administrative fee of 100€ will be charged.

ENS CONFERENCE

organised in collaboration with: