Please check the contents of this form carefully as you will not be able to make modifications after submission. If it is necessary to change any information after submission, please e-mail or fax the changes to the Congress Business Travel Ltd.:email@example.com; fax: +420 224 942 550.
For your convenience this web form will remember your personal data during the session. You will be asked to re-enter your personal data if you close this window or stay on this page for more than 60 minutes without submitting.
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Title, First name
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Landline phone (+420 123456789)
Mobile Phone number
I agree with the use of my personal data by the company Congress Business Travel spol., s r.o., in accordance with the Czech Personal Information Protection Act 101/2000 Sb. The data will be used solely for the purposes of this conference; giving consent is a necessary condition of your registration.
Registration fee includes
All fees are stated in local currenzy Czech Crowns (CZK) and include local VAT tax (21%).
Library tours offered by the hosting institution (tours are limited and will be confirmed on a first come, first served basis).
I authorize Congress Business Travel Ltd. (Lidicka 43/66, 150 00 Prague 5, Czech Republic, VAT number: CZ26424053) to charge my credit card for the payment of the above sum CZK: According to the Czech law, credit cards will be charged in local currency / Czech Crowns (CZK) by actual exchange rate.
Card typeSelectAmerican ExpressVISAMasterCard/EuroCardDiners
Card holder's name*
Expiry date (mm/yy)
CVV/CVC code (last 3 digits)**
Billing address (AMEX)
*) In case the name of the cardholder and name of the registered delegate is different, the conference secretariat has the right to ask the cardholder for verification. Please fill in all the requested data and contact the conference secretariat for further details. The secretariat will send you a special form for verification.
**) The CVC2 (MasterCard/EuroCard) or CVV2 (American Express, Visa, Diners) code is printed on the reverse side of your credit card on the signature panel, (last three digits).
In case you need to issue an pro-forma invoice or if someone else is paying your registration fee, please, tick the following box.
Also kindly state in the VI. Notes section if you require pro-forma invoice.
VAT tax invoice will be sent to your listed e-mail address after the payment is received.
The paper invoice you can pick up at the registration desk at the conference.
Different payer or invoice.
Invoice addressMailing Address
Phone+ (+420 123456789)
VAT number your institution
Your Invoice PurchaseOrder Number
Please add any information you regard as important
All fees are quoted in CZK (Czech crowns) and include 21% VAT. Tax invoices will be issued automatically upon receipt of payment. Tax invoice will be sent to registered e-mail address in this form. You can also pick up the original invoce at the registration desk during the conference.
Organizing Secretariat Congress Business Travel Lidicka 43, Prague 5
Phone: (+420) 224 942 575, 224 942 579 Fax: +420 224 942 550 Email: firstname.lastname@example.org http://igelu.org