Registration form
ELCOREL - Workshop 28 - 30 January 2019, Liblice (Prague)
Participant details
Title
First Name
Family Name
Institution
Billing Address
E-mail address
Cell phone

Package selection
Whole week, 5 nights Sun-Fri
ELCOREL-ESR fellow, shared room
EURO 465.00
ELCOREL-Senior members
EURO 565.00
2.5 days, 3 nights Sun-Wed
Other participants in shared rooms
EURO 355.00
Other participants in single rooms
EURO 395.00
Will share room with:

Payment
Bank Transfer

Diet / Allergy
Other