Logo konference Opportunities and risks of distance education
23rd - 25th June 2010, Pilsen, Czech Republic

Registration form

Please, fill in the registration form by 5th June 2010.

Mr. Mrs.
Family name:
First name:
Nationality:
Institution:
Address:
Post code:
City:
Country:
Phone:
Fax:
E-mail:
Note:

Conference dinner
Please mark YES if you plan to attend the conference dinner. The conference dinner is included in the registration fee.

Please indicate the number of accompanying guests that will participate in the conference dinner. The price of the conference dinner is 600 CZK for each of your guests. 		Conference dinner
Participation: YES NO
No. of accompanying guests:

Social events
Please indicate if you plan to attend our social events. All social events are included in the registration fee.

Please indicate the number of accompanying guests that will participate in the social events. The price of each social event is 150 CZK for each of your guests.		 Bohemia Sekt Centre visit
Participation: YES NO
No. of accompanying guests:

Pilsner Urquell brewery visit
Participation: YES NO
No. of accompanying guests:


 

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