Registration form First name: Surname: Email address: Institution: under 30 years of age member of CHNCCG No active participation Presentation in a form of lecture Presentation in a form of poster Title of presentation: Presentation author(s): Department(s): I want to specify billing address Institution name: Contact person: Billing address: CRN / IČ: TIN / VAT ID / DIČ: Email for billing: Registration fee Before May, 1 2018 After May, 1 2018 and on site Residents under the age of 30 1750 CZK / 70 EUR 2050 CZK / 82 EUR — members of CHNCCG 1550 CZK 1850 CZK Specialists / consultants 2750 CZK / 110 EUR 3050 CZK / 122 EUR — members of CHNCCG 2550 CZK 2850 CZK Registration fee payment by bank transfer (preferred) Registraton fee payment online by credit/debit cards, online bank transfer, mobile payment and paypal/gopay. Currently unavailable, we are working on enabling online payment as soon as possible. Registration fee will be payed on site. Payment information: The corresponding registration fee should be paid concurrently with the registration by bank transfer. Please indicate your name in the message for receiver. Account number: 266694759 / 0300 IBAN: CZ83 0300 0000 0002 6669 4759 BIC/SWIFT: CEKOCZPP Payment information: We are using GoPay payment gateway, supporting variety of safe and secure online payment methods. After submitting your registration, you will be taken to GoPay gateway to make your payment. Supported credit/debit cards: Mastercard, Mastercard Electronic, Visa, Visa Electron and Maestro. You can make pay with PayPal or even with bitcoins. You agree with Registration Terms and Conditions Submit registration In case of any difficulty during registration payment process please contact us at email@example.com. Thank you.