ICRM 2019

27/31 May, 2019
Salamanca, Spain

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Registration Form

ONLY FOR ALREADY REGISTERED USER

When you register you will receive a registration code and a password that should be used if you wish to register an accompanying person in the future.

Complete the following fields and click COMPLETE DATA to register an accompanying person in the future.

Registration Code

Password:

PERSONAL DATA

Mr. Ms.

First Name:

Family Name:

Identity document:

Number:

Nationality:

Date of birth:

Format: dd/mm/yy

Personal Address:

Zipcode:

City/Town:

Province / State:

Country:

Tel.:

Fax:

E-mail:

Repeat E-mail:

Institutional affiliation - Department Company:

Title (PhD/Prof/Other):

Terms:

Regarding the L.O.15/1999 law of December 13, which deals with the treatment of personal information and databases, we would like to inform you of the following:
 
 A.- The data provided by the user will be added to a database which is kept, owned and managed by Congresual SLL, and Congresual SLL the responsible party for any use of such information. The fiscal information of Congresual SLL is: CIF B-37495116 and address: C/ Camelias 470 .  CP 37449  Galindo y Perahuy (Salamanca). The database is being registered in the General Register for Databases and it has the required code, which is assigned by the Spanish Data Protection Agency.
 
 B.- Congresual SLL guarantees the confidentiality of all the information provided by the user. The obtaining and management of the data is done following strict levels of security apart from the levels required by law in order to assure that such confidential information may not be lost nor obtained by a third party.
 
 C.- Following the current legislation, all users of Congresual SLL Server have the right to enter, modify or cancel his/her personal data. If the user chooses to cancel the personal information previously given to Congresual SLL, after the user logs off, all confidential information will be erased from the system, except information related to historical or statistical purposes.
 
 In order to modify the previously mentioned information, the user must do so in writing, by sending a formal allowance to Congresual  by regular mail to the following address:
 
 Congresual SLL, C/ Camelias 470 .  CP 37449  Galindo y Perahuy (Salamanca)

I have read and I agree the terms that appear in this registration form

Required fields

INVOICE DETAILS (if different than the above)

Initially the invoice will be fill in with the information provided in this registration form. If you need any change in your invoice, please use the box below:
-The official invoice will be provided directly in the conference-

Institution/Company Name:

Institution/Company Address:

Zipcode:

City/Town:

Province:

Country:

VAT Number:

Please, you should complete the Identity Document or the VAT Number for your invoice.

REGISTRATION FEES

UTC + 1

Early Bird
Until March 15th, 2019

Regular
From March 16th, 2019

Standard registration ⁽¹⁾

450,00 €

520,00 €

Accompanying person ⁽²⁾

330,00 €

400,00 €

(1) Includes: conference sessions, welcome cocktail, lunches, coffee breaks and conference dinner.
(2) Includes: accompanying person programme, welcome cocktail and conference dinner.

ADDITIONAL INFORMATION – Food intolerances

Without restrictions

With restrictions

Vegetarian

Strict vegetarian

Celiac

No pork

Other

HOW TO PAY

Bank Transfer

Bank transfer payable to UNICAJA bank:

Account Number: 2103 2214 5100 3640 3500
IBAN: ES82 2103 2214 5100 3640 3500
B.I.C. / Swift Code: UCJAES2MXXX
CONCEPT OF PAYMENT: ICRM2019 NAME + LAST NAME
ISSUE EXPENSES: by the payer

Owner of the Account Number: (Technical Secretariat)
CONGRESUAL, S.L.L. (VAT number: B-37495116)
Address: C/ Camelias, 470 -37449 –Galindo y Perahuy (Salamanca) Spain.

Send a copy of the transfer indicating the concept of payment to: registrationicrm2019@congresual.com

Only VISA or MasterCard Credit Cards

You will be transferred directly to the secure on-line payment (directly with the bank).
This process will be done through the secure area of the bank.
This is an automatic process. If you have any problem, please contact with your bank.

CANCELLATIONS

75 € will be charged if the cancellation is made until May 10th. (management fees). After that day, the registration fee will not be refund.

VALIDATION CODE

Validation Code:



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