Electrochemistry of Nucleic Acids and Proteins: 
New Tools for Biotechnologies 
Brno, CZ June 19-22, 2008

Registration form

(please fill in and send by e-mail to jelen@ibp.cz) 

Last name, first name, middle initial:

Titles:		

Affiliation (including address):
		
E-mail:
		
Phone:
		
Fax:

Accompanying person 
(last name, first name, middle initial)

Preferred form of presentation:	 talk		 poster 

Abstract of brief oral presentations will be selected by the Scientific Committee after closing the abstract submission (March 10). Authors will be notified of the decision by March 31.

Accommodation in the Orea Santon Hotel:

Room reservation 
(prices per night, including VAT 19%, valid for EUR:CZK=1:25 exchange rate):

   single (68 EUR)   

   double, shared (34 EUR per person)    male	 female

I wish to share double room with: ………………………………… (last name, first name)

Date of arrival: ………………………….

Date of departure: ………………………

Bank transfer payment2:

	Before 
April 15	After 
April 15	please fill in here	

Registration fee
	220 EUR	270 EUR	
…………..	

Accompanying person fee
	95 EUR	120 EUR	
…………….	

Total
	……………	

2Registrants will be notified by e-mail after payment has been received.

To be filled in by anyone who requests an invoice/receipt:

Full name of participant (or list of participants in the case of collection payment):		
Exact invoice address of organization/payee of registration fee (Bill to):		
Company ID number, if any:		
VAT identification number (DIČ):		
Date of payment: (if already paid)		
Amount paid: