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10th Congress
of Chemical Technology

Registration

Page 1/5

Title *

First Name *

Surname *

University or Organization *

Faculty/Unit

Position *

Page 2/5

Contact details

Address (Street, No.) *

City *

Zip code *

E-mail *

Phone Number *

Page 3/5

Participation in the Congress

Participant *

Technological problem

Please fill if Company + Incubator is selected

Contact Person

Please fill if Company + Incubator is selected

Proposed Award

Please fill if Company + Incubator is selected

Number of accompanying persons *

Role *

Type of presentation

Please fill if Presenter is selected

Presentation Title

Please fill if Presenter is selected

Co-authors

Please fill if Presenter is selected

Abstract and CV file

Please send if Presenter is selected
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Page 4/5

Invoice data

Institution

Address (Street, No.)

Zip code

City

Tax number

Page 5/5

Personal data procession

Declaration of personal data procession *

[declaration text]

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