REGISTRATION FORM IN A PDF FILE       
(for printing)

The application form shall be sent together with a photocopy of the payment receipt by post, fax or e-mail to the Conference Organizer untill

22th February 2012

Applications received after this deadline will be accepted only when there are vacancies remaining.

Conference Organizer:

Targi w Krakowie Ltd.

PL - 31-586 Kraków, 41A Centralna Str., Poland

tel. +48 12 651 90 48, fax +48 12 644 61 41

e-mail: kursy@targi.krakow.pl

Bank account: ING Bank Śląski, Krakow Branch

IBAN PL 82 1050 1445 1000 0022 9166 0138 No. BIC (SWIFT): INGBPLPW

All costs of bank transfers should be paid by the participant.

Price includes:

conference materials, name badge, lunch (only during the conference!), coffee breaks, certificate, free entry to 20. International Trade Fair

KRAKDENT® and to exhibitors’ presentations.

Proof of payment shall be enclosed with the application forms, otherwise the applications will not be registered.

Application forms shall be enclosed with proof of payment, otherwise the proof of payment will not be registered.

In the case when there are no vacancies, the Organizer reserves the right to reject an application form.

In the case of resignation from participation

until 22th February 2012 the Participant is entitled to the reimbursement of 50% of the paid fee. In the case of resignation from participation

from 23rd February 2012 the Participant is not entitled to any reimbursement.

The Organizer reserves the right to make changes in the scientific programme due to circumstances that are beyond his control – in the case of any changes, the current version of the programme will be available on the following website:

www.dentalspaghetti.pl.

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