Application - Konferencja PTPPd

Application form

We kindly invite you to come on a Friday conference day, as the first day will not be in English. English speaking participants will be given translated materials from Thursday presentations.

We kindly inform, that participation in the Conference is confirmed only after paying the conference fee.

Please make the payment without delay due to the large number of people interested in the conference and limited number of places.
If you fail to make the payment within 14 days of notification for participation, your reservation will be cancelled.

NOTE!

While making a bank transfer, please select the OUR option, which means that you pay for the transfer and do not have to share costs. Otherwise we will get an incomplete payment and you will have to pay again the difference to make it complete.

If there is no way to make a fee transfer in PLN the cost of the Conference must be paid in Euro (€) or US dollars ($) according to the prices at Conference fee

Fields marked with an asterisk are mandatory.

Surname*:

First Name*:

Email*:

Telephone number*:

Billing address information:

Company name*:

Street*:

House number*:

ZIP kode*:

City*:

Country*:

NIP:

Postal address - please indicate if it is different than the invoice address:

Street:

House number:

ZIP kode:

City:

Country:

Please mark if you are a member of the Polish Society for Psychodynamic Psychotherapy

Please mark if you a are a medical doctor

How you found out about the conference?

Other sources:

^* I hereby give my consent for the gathering, processing and use of my personal data for purposes related to the process of registration, compiling and managing the participant base for the scientific conference organised by the Polish Society for Psychodynamic Psychotherapy. This consent also covers the processing of personal data regarding further scientific conferences.

I hereby give my consent to the Polish Society for Psychodynamic Psychotherapy to send me commercial information at the indicated email address and phone number and to use data terminal equipment and automatic calling systems for the purpose of direct marketing connected with goods and services, in particular for the purpose of advertising and invitations to participate in further scientific conferences and other events connected with the statutory objectives according to the Law 18.7.2012 concerning electronically supplied services (Dz. U. 2002, No. 144, item 1204 and its subsequent amendments) and according to the Law 16.7.2004 about telecomunications law (Dz. U. No. 171, item 1800 and its subsequent amendments).

The Administrator of the personal data provided is the Polish Society for Psychodynamic Psychotherapy (56 Zamoyskiego St., 30-523 Cracow), entered in the register of societies, other social organisations, foundations and Independent Public Healthcare Centres under KRS No: 285776, NIP: 676-92-40, REGON: 120520347. The data subjects have the right to request the correction of their personal data and the right to demand cessation of its processing.

Conference fee

Early payment, until May 31, 2019

80 € / 90 $ One conference day, Friday
160 € / 185 $ Two conference days (Thursday will not be translated)

Late payment, after May 31, 2019

90 € / 100 $ One conference day, Friday
190 € / 210 $ Two conference days (Thursday will not be translated)

Conference fee is for: conference materials, catering.

We kindly invite you to come on a Friday conference day, as the first day will not be in English. English speaking participants will be given translated materials from Thursday presentations.

Payment:

Polskie Towarzystwo Psychoterapii Psychodynamicznej / Polish Society for Psychodynamic Psychotherapy

Zamoyskiego St. 56

30-523 Kraków

Alior Bank Spółka Akcyjna nr: 58 2490 0005 0000 4530 4197 4624

IBAN: PL58 2490 0005 0000 4530 4197 4624

kod SWIFT (BIC): ALBPPLPW

"Psychodynamic psychotherapy for children, adolescents and young adults"

Krakow, 5-6 September 2019

Application form

Conference fee