Registration Form

Please fill in this form to register to Spin-Praha-2015. We also accept e-mail with the same information, but electronic submission of this web form is strongly preferred.

Deadline is July 20, 2015

Prof. Dr. Mr. Ms. or  Other:

Family name:

Name(s):

Institution (full name):

Home Institute address:

Phone (office):

FAX:

E-mail:

I am planing to give a talk:
Preliminary title:

Preliminary arrival date:


Preliminary departure date:


I am planing to reach Prague

by plane, flight N


by train, N


by car


Visa Information

If you need the visa for Czech Republic, please, specify



Date, month and year of birth:

Sex:

Citizenship:

Passport number:

Date, month and year of issue:

Date, month and year of expiration:

Place of applying for the visa:

(country and city in which the Czech Consulate is available)


Accompanying Person(s)

Name(s):

(children under 16, if any, name and year of birth)


Housing Reservation

  • I take care of the accommodation by myself                 
  • I will use the service of Organizing Committee and book 
    - Hotel Pawlovnia, (***)
    Single room, 1000,- CZK/ night (40 Eur/night)
    Double room, approx 1400,- CZK/ night (56 Eur/night)
    - Rezidence DZS MSMT, (***) standard
    Single room, 1550,- CZK/ night
    Double room, 1990,- CZK/ night

  • I will share room with:


accommodation and housing information


I would like to draw attention of the Local Organizing Committee to the following requirements and/or comments:

Comments: