Please note that all form fields marked with asterisk (*) are required.

BASIC INFO

Title:

First Name:*

Family Name:*

Institution:*

Address:*

ZIP code:*

City:*

Country:*

E-mail:*

I plan to present a poster contribution:*
YesNo
Tentative title of the presentation:

Registration fee (till July 1, 2017)

Free registration for young C-MAC scientist (one per C-MAC member).
Indicate the supervisor name:

and host institution:

or

Early-stage C-MAC scientists: 200 EUREarly-stage non-C-MAC scientists: 250 EURSenior C-MAC scientists: 250 EURNon-C-MAC participants: 300 EUR

Please note that registration fees after July 1, 2017 will be increased by 50 EUR.

Accommodation Reservation

Organizer ensures accommodation in student dormitory in both single and double rooms with breakfast included. Number of single rooms is limited.

I will arrange my own accommodationI would like you to make a dormitory reservation in my name

Room type:
Single occupancy (29 EUR/night/person)Shared occupancy (25 EUR/night/person)
please, indicate preference for sharing:

Arrival date:*

Departure date:*

Special requests, if any: (dietary, accessibility, extended accommodation period etc.)

Important information about payment:

• In the case of dormitory accommodation, participants pay on checkout, either by cash or by credit card.
  Reservations will be confirmed by email by July 20, 2017.

• Registration fee have to be paid by bank transfer until September 10th, 2017.
  Cash payment upon arrival is not possible.
  Bank details:
  Splitska banka d.d.
  Rudjera Boskovica 16
  HR-21000 Split
  Croatia
  Account holder:
  University of Split
  Faculty of Science
  Rudjera Boskovica 33
  HR-21000 Split
  Croatia

  IBAN: HR1723300031100068831
  SWIFT (BIC): SOGE HR22
  Reference: C-MAC + Participant’s Surname

Remark:
Participants from Croatia pay fee and accommodation in Croatian Kunas (HRK).
- Early-stage C-MAC scientists: 1,500 HRK
- Early-stage non-C-MAC scientists: 1,875 HRK
- Senior C-MAC scientists: 1,875 HRK
- Non-C-MAC participants: 2,250 HRK

- single room: 212 HRK/night/person
- double room: 182 HRK/night/person