Registration Form

Early Registration Deadline: September 12, 2013

Registration Deadline: October 21, 2013

Tax and Contact details

* Required fields

Title:
* Surname:
* First name:

Billing details:
* University/Company:
Faculty:
Department:

* Street:
* Town:
* Post code:
* Company Registration Number of Payer:	(If not applicable, please fill "NO")
* Registrated VAT Number of Payer:	(If not applicable, please fill "NO")

Phone:
Fax:
* E-mail:
www:

Organizational and Payment details

I order lunch on October 24, 2013 (Thursday)

I will attend the CONFERENCE only on October 24 - 25 only (Thursday, Friday morning)

I will attend the CONFERENCE on October 24 - 25 (Thursday afternoon and Friday) and WORKSHOP on October 24 (Thursday afternoon)

I will attend the CONFERENCE on October 24 (Thursday) and the EDUCATIONAL SECTION on October 25 (Friday morning)

I will attend the WORKSHOP only on October 24 (Thursday afternoon)

Registration Fee

Early bird before September 12, 2013:	2 800 CZK		after September 12, 2013:	3 200 CZK
Early bird CONFERENCE and WORKSHOP registration fee before September 12, 2013:	3 000 CZK		after September 12, 2013:	3 400 CZK

Reduced registration fee (20% discount from Regular fee applies for Members of the Czech and Slovak Society for Photonics, IEEE Members and academic authors with non-commercial contributions):

I am the Member of the Czech and Slovak Society for Photonics
I am the Member of the IEEE
I am working at university/academic field

Early bird reduced fee before September 12, 2013:	2 240 CZK		after September 12, 2013:	2 560 CZK
Early bird CONFERENCE and WORKSHOP reduced registration fee before September 12, 2013:	2 400 CZK		after September 12, 2013:	2 720 CZK

Registration fee for WORKSHOP only:

1 200 CZK

Registration fee for Educational Section:	600 CZK
Lunch on October 24, 2013:	260 CZK
TOTAL:

All fees are including 21% VAT.
The registration fee applies also to authors (apart from invited speakers and members of the program committee).
We do not confirm the receiving of the registration. We will contact you in case of any problems.

We offer the ability to register for the CONFERENCE for the students of master's, bachelor's degree and secondary schools with the recommendation of members of the conference program committee.

I am a student of master's, bachelor or secondary school
Referred by a member of the PC:

Confirmation of free participation at the conference will be sent in case of a positive application acknowledgement. (The amount of registration fee to be filled in is "0")

Date of payment:
Number of bank account:

Payment has to be made in Czech Crowns. Please transfer the payment to the following account:
CZK Account Number: 221442101/0100 IBAN: CZ0801000000000221442101
Swift Code: KOMBCZPP, in Czech Republic using "variabilni symbol" 2510
Czech Republic, Komercni banka Prague 10, Kubanske nam. 15, account holder - Milena Zeithamlova, Agentura Action M, address - Czech Republic, Prague 10, Vrsovicka 68,
Company Registration Number: 16996771, Company Vat Number: CZ6162270202