ecbs2019euchems

* Fields marked with a red asterisk are mandatory

Personal details of the participant

Surname:*

First name:*

NIF/ Passport:

Nationality:

Address:*

Post Code:*

City:*

State/Region/Province:*

Country:*

Telephone:*

E-mail address:*

Affiliation/Institute:*

Visa invitation letter

Do you require a Visa invitation letter?* Yes No

Billing information

Do you require an invoice for your registration?* Yes No

*The invoice will be sent within one week.

Registration fees *

Industry 450.00 €

PhD Students / Postdocs 275.00 €

Academia 395.00 €

Conference Dinner 40.00 €

Special Needs

Please indicate any special needs you may have concerning your attendance and participation at the meeting (disabilities, etc.), and any indications regarding the meeting lunches and dinners if you will be attending (vegetarian, celiac, allergies, etc).

Total amount

Method of payment

Bank transfer payable to:

Account holder:	Fundación General de la Universidad de Alcalá
Bank:	CAIXABANK
Address:	c/ Libreros, 10. 28801 Alcalá de Henares (Madrid)
Account number:	2100 4615 5813 0094 8031
IBAN code:	ES13 2100 4615 5813 0094 8031
Swift code:	CAIXESBBXXX

Visa/Mastercard Credit Card

Basic information about data protection

I accept the Privacy policy regarding the treatment of personal information in order to the basic information about date protection detailed bellow

Responsable: FUNDACIÓN GENERAL DE LA UNIVERSIDAD DE ALCALÁ. Imagen St., 1-3 (28801 Alcalá de Henares). Purposes: Management and organization of the activity, also the pictures and information data base about future events with the same thematic that may be of interest for you. Data: Identification data, contact data, financial data and health data (allergies) and disabilities. During the celebration of the event, pictures will be taken and videos will be recorded with the purpose of public dissemination, for video playback or real time broadcast and for its conservation in the pictures data base of the Fundación. Legality: Acceptance and legitimate interest. Communications: Your information will be only communicated to the organization of future editions to the same events and to the people in charge of the treatment of the activity, for the stated purpose, and in the cases provided by law. Rights: To access, rectify and delete your data, also to unsubscribe or object to the processing of the data, restrict it and other rights that you can check in our Privacy Politic. To exercise your rights, you can contact our data base officer: dpd@fgua.es
Complete information about our privacy politic: https://www.fgua.es/politica-privacidad/.

Registration form

Registration form