Plenary speaker registration for IDS13

Personal information

First name *

Surname *

University / Company / Organization etc. *

Address *

ZIP code *

Town *

Country *

Email *

Cell phone number *

Telephone number office *

Invoice information (in case of accompanying person/persons)

I wish to pay by

invoice

credit card (we will send you a link by email)

Company / University / Organization

Department

Invoice address

PO Box

ZIP code

Town

Reference for invoice (example for electronic invoices: ZZTYMRPK... for Swedish universities)

Invoice address (email)

Other information

Other

I am aware that photos will be taken during the IDS13 conference

YES

NO

I agree that my name and e-mail will be publiched in a digital participants list, which will be accessible to Svenska Kemisamfundet and KTH. (Only in connection with IDS13 conference)

YES

NO

I agree to storage of personal contact information by Svenska Kemisamfundet, according to the personal data policy Kemisamfundets personuppgiftspolicy

YES

I have read and agree to apply to the meeting's code of conduct.

YES

If you are human, leave this field blank.

Personal information

Participation

Invoice information (in case of accompanying person/persons)

Other