NanoSD 2018

REGISTRATION

NanoSD 2018 Conference
Madrid (Spain) December 11 - 12, 2018

Registration Form

Gender(*)	Male Female
Title(*)
First Name(*)
Last Name(*)
Institution/Dept.(*)
Address(*)
City(*)
ZIP Code(*)
Country(*)
Phone(*)
Fax(*)
E-Mail(*)
VAT Number
Doctoral Student (*)

NanoSD Conference Fees

Participants

	Before November 27	After November 27
Senior	285 Euros	385 Euros
Student (*)	190 Euros	290 Euros

Exhibition Fee

	Before November 19	After November 19
(Stand 2X1,5 m2 - Space rental)	700 Euros	950 Euros

(*) Justification signed by your PhD Adviser should be sent by e-mail (antonio@phantomsnet.net)

Additional Info

Arrival Date: Departure Date

Do you submit a contribution?

Vegetarian?

P A Y M E N T

(*) For Credit Card payment, a 2,5% (bank costs) will be applied.

1) Bank transfer to the order of "Fundacion PHANTOMS" must bear the mention "FREE OF CHARGE TO THE RECEIVER" and must indicate NANOSD2018 Conference and LAST and FIRST NAME of the participant to facilitate identification and to the following bank account:

    CaixaBank SA, Calle Ibiza 64, 28009 Madrid (Spain)
    BIC (Bank Identifier Code): CAIXESBBXXX
    IBAN (International Bank Account Number): ES55 2100 6441 5122 0002 0128
    Phantoms Foundation VAT Number: ES G83352724

PLEASE, SEND BY email (antonio@phantomsnet.net) A COPY OF YOUR BANK TRANSFER MAKING CLEAR THE NAME OF PARTICIPANTS TO NANOSD2018 CONFERENCE.
ALL BANK CHARGES SHOULD BE PAID BY THE APPLICANTS.

2) Credit card [ VISA - MasterCard ]

To validate the Registration Form, please write the following code:

CANCELLATION OF CONFERENCE PARTICIPATION
All cancellations should be made in writing by e-mail to Dr. Antonio Correia.
Your payment less 50 Euros will be reimbursed, if a cancellation is received before October 22, 2018
50% of the registration fee payment will be reimbursed, if a cancellation is received between October 23 and November 12, 2018
No reimbursement will be made after November 12, 2018

INSURANCE
The Organisation Committee will not be responsible for any medical expenses, lost property, or accidents during the NanoSD Conference and we strongly recommend that participants make all necessary insurance arrangements for themselves.