QUESTE_09_RegForm_AJ

CTU in Prague
Colloquium “Industry – University Working Together in Europe to Produce the Leaders for Tomorrow
11 – 12 June 2009, Prague – Czech Republic
Venue: CTU in Prague, National Technical Library – entrance NTK 4, Technická 6, Praha 6 – Dejvice
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REGISTRATION AND ACCOMMODATION FORM
Please complete this form and return it to the fax number +420 224 352 666 or +420 224 310 292
(if payment is made by credit card) or by e-mail to: [email protected] by 22 May 2009.
Notice: to move between fields you have to fill in, use skip key or arrow-heads
PERSONAL INFORMATION
First name:
Last name:
Institution:
Postal Code:
City:
Country:
Phone:
Fax:
E-mail:
Vegetarian meals, diet (specify)
FEES
no
yes
(in EUR)
Registration fee per person (includes: coffee breaks, lunches, Gala Dinner, meeting rooms)
Do you intend to participate in a Gala Dinner on 11 June?
yes
1
no
120
free of charge
Gala Dinner fee for the accompanying person/s (30 EUR/person)
Accommodation - total amount due: hotel
number of nights:
room: single
double
twin
date of arrival:
date of departure:
- Confirmation of receiving your payment will be sent to you by e-mail.
- The quittance for the fees will be handed at the Meeting Registration Desk. If a tax document
is required, please fill in table below:
I ask for a tax document
1)
1)
no
yes
Total amount due:
VAT ID:
Tax document will be given to the participant at the Meeting Registration Desk.
Full Invoicing Address:
fill in if you ask for a tax document
PAYMENT BY CREDIT CARD
Acceptable Card Types: embossed VISA, EURO-MASTER, DINERS CLUB, JCB
Signature
I hereby authorize CTU in Prague to charge below-mentioned card
2)
with the amount EUR :
Credit Card Holder:
Card Type:
Expiry Date:
Card Number:
CVC/CVV
2)
3)
3)
According to the Czech law, cards will be charged in local currency - Czech crowns (CZK). The Conference Secretariat will use the
exchange rate of the Czech National Bank on the date of payment. The approximate exchange rate is 1 EUR=26,80 CZK (May 2009)
CVC, CVV = last 3 digits of the number on the reverse side of the card near the signature
PAYMENT BY DIRECT BANK TRANSER
EUR is to be sent to the account of CTU (more information - see page 2 of this form).
Information needed for direct Bank Transfer
Please note that all direct bank transfer charges must be covered by the participant
(method of payment = “OUR”).
Bank:
Account name:
Account Number:
IBAN:
SWIFT = BIC:
Company ID (IČO):
VAT ID (DIČ):
Details of payment:
Komercni banka, Dejvicka 52, 160 59 Praha 6, Czech Republic
CVUT v Praze – Fakulta strojni, Technicka 4, 166 07 Praha 6 – Dejvice
19-5505030267/0100
CZ 4201 000 000195505030267
KOMBCZPPXXX
68407700
CZ68407700
44090006
(Please do not forget to add your name to enable identification of payment.)
Accommodation
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The price of the accommodation includes bed, breakfast, city charges and 9% VAT.
The prices are valid if your order is sent to the Meeting Secretariat, only (not to the hotel).
The prices are ceiling we will charge – if we obtain “last minute” price when you ask us to book your hotel
room, we will charge lower price (about lower price for the accommodation you will be informed by e-mail).
This is no concern hotel Pyramida and Novoměstský hotel.
Hotel assignment will be made on the first-come, first-serve basis; therefore it is advisable to make
reservation of accommodation as soon as possible.
Minimum one night deposit is required; the balance would be paid at the Meeting Registration Desk.
Hotel voucher will be mailed to you by e-mail by 3 June 2009.
If you do not like any hotel arranged by Meeting Secretariat, you can book hotel by yourself. A lot of “Special” and
“Last minute” offers of the accommodation you can find at internet.
Hotel/hostel - category
Single
Room
Double
or Twin
EUR
EUR
1. Palace *****
2. Crowne Plaza - standard ****
3. Diplomat - standard ****
190
120
105
190
120
105
4. Pyramida ****
100
110
5. Waldstein hotel****
100
110
6. Mucha****
90
100
80
80
80
50
100
80
100
55
7. Silenzio****
8. Denisa ****
9. Novoměstský hotel ***
10. Sofia ***
The way to the
Meeting venue
metro A
705 m on foot
620 on foot
bus 217, 143, 149
or tram 36
metro A
metro B + A
or tram 8
870 m on foot
725 m on foot
metro A
metro A
Address
Panská 12, Praha 1 – Nové Město
Koulova 15, Praha 6 – Bubeneč
Evropská 15, Praha 6 – Dejvice
Bělohorská 24, Praha 6 – Břevnov
Valdštejnské nám. 19/6, Praha 1-Malá Strana
Sokolovská 26/65, Praha 8 – Karlín
Na Karlovce 2565/1b, Praha 6 – Dejvice
Národní obrany 33, Praha 6 – Dejvice
Řeznická 4, Praha 1 – Nové Město
Americká 28, Praha 2 – Vinohrady
Cancellation Fees and Refunds
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Registration forms received without appropriate remittance will not constitute advance registration and will not
be processed.
Any changes regarding the registration should be made in writing to CTU in Prague.
Substitution of participants within the same company, after a registration fee has been paid, is acceptable at
any time and no extra fee is payable.
In case of cancellation up to 29 May 2009, the paid registration fee will be refunded with a deduction of 15
EUR for administrative charges.
No refund of the registration fee will be applicable for cancellations received after 29 May 2009.
In case of cancellation hotel booking after 3 June 2009 one night deposit will be charged.
Refunds will be settled after the Meeting – to your credit card or to your account (information needed to
refund: name of your bank, address of your bank, account name, account number, IBAN, SWIFT/BIC,
eventually your details of refund).
*For more information visit Meeting web site
http://mech.fsik.cvut.cz/QUESTE