Registracija * obavezna polja Sudionik Ime * Prezime * OIB * Note: samo za građane RH - 11 znakova Titula MD DO PhD RN Ostalo Ostalo: Institucija * Adresa * Poštanski broj * Grad * Zemlja * Odaberite... Afghanistan Åland Islands Albania Algeria American Samoa Andorra Angola Anguilla Antarctica Antigua and Barbuda Argentina Armenia Aruba Australia Austria Azerbaijan Bahamas Bahrain Bangladesh Barbados Belarus Belgium Belize Benin Bermuda Bhutan Bolivia, Plurinational State of Bonaire, Sint Eustatius and Saba Bosnia and Herzegovina Botswana Bouvet Island Brazil British Indian Ocean Territory Brunei Darussalam Bulgaria Burkina Faso Burundi Cambodia Cameroon Canada Cape Verde Cayman Islands Central African Republic Chad Chile China Christmas Island Cocos (Keeling) Islands Colombia Comoros Congo Congo, the Democratic Republic of the Cook Islands Costa Rica Côte d'Ivoire Croatia Cuba Curaçao Cyprus Czech Republic Denmark Djibouti Dominica Dominican Republic Ecuador Egypt El Salvador Equatorial Guinea Eritrea Estonia Ethiopia Falkland Islands (Malvinas) Faroe Islands Fiji Finland France French Guiana French Polynesia French Southern Territories Gabon Gambia Georgia Germany Ghana Gibraltar Greece Greenland Grenada Guadeloupe Guam Guatemala Guernsey Guinea Guinea-Bissau Guyana Haiti Heard Island and McDonald Islands Holy See (Vatican City State) Honduras Hong Kong Hungary Iceland India Indonesia Iran, Islamic Republic of Iraq Ireland Isle of Man Israel Italy Jamaica Japan Jersey Jordan Kazakhstan Kenya Kiribati Korea, Democratic People's Republic of Korea, Republic of Kuwait Kyrgyzstan Lao People's Democratic Republic Latvia Lebanon Lesotho Liberia Libya Liechtenstein Lithuania Luxembourg Macao Macedonia, the former Yugoslav Republic of Madagascar Malawi Malaysia Maldives Mali Malta Marshall Islands Martinique Mauritania Mauritius Mayotte Mexico Micronesia, Federated States of Moldova, Republic of Monaco Mongolia Montenegro Montserrat Morocco Mozambique Myanmar Namibia Nauru Nepal Netherlands New Caledonia New Zealand Nicaragua Niger Nigeria Niue Norfolk Island Northern Mariana Islands Norway Oman Pakistan Palau Palestinian Territory, Occupied Panama Papua New Guinea Paraguay Peru Philippines Pitcairn Poland Portugal Puerto Rico Qatar Réunion Romania Russian Federation Rwanda Saint Barthélemy Saint Helena, Ascension and Tristan da Cunha Saint Kitts and Nevis Saint Lucia Saint Martin (French part) Saint Pierre and Miquelon Saint Vincent and the Grenadines Samoa San Marino Sao Tome and Principe Saudi Arabia Senegal Serbia Seychelles Sierra Leone Singapore Sint Maarten (Dutch part) Slovakia Slovenia Solomon Islands Somalia South Africa South Georgia and the South Sandwich Islands South Sudan Spain Sri Lanka Sudan Suriname Svalbard and Jan Mayen Swaziland Sweden Switzerland Syrian Arab Republic Taiwan, Province of China Tajikistan Tanzania, United Republic of Thailand Timor-Leste Togo Tokelau Tonga Trinidad and Tobago Tunisia Turkey Turkmenistan Turks and Caicos Islands Tuvalu Uganda Ukraine United Arab Emirates United Kingdom United States United States Minor Outlying Islands Uruguay Uzbekistan Vanuatu Venezuela, Bolivarian Republic of Viet Nam Virgin Islands, British Virgin Islands, U.S. Wallis and Futuna Western Sahara Yemen Zambia Zimbabwe Fax Telefon * E-Mail adresa * Kotizacija Odaberite kotizaciju: 1.500,00kn Rana kotizacija (do 25.03.2015.) 1.700,00kn Kasna kotizacija (nakon 25.03.2014.) 1.000,00kn Rana kotizacija za specijalizante i znanstvene novake (do 25.03.2015.) 1.200,00kn Kasna kotizacija za specijalizante i znanstvene novake (nakon 25.03.2014.) Dodatne opcije 500,00 kn Kotizacija za osobu u pratnji Ime osobe u pratnji Molimo unesite ime i prezime osobe u pratnji ako je ima. Smještaj - rasprodano Ako vam je potreban smještaj molimo odaberite ga zajedno sa datumom dolaska i odlaska. Cijene sadrže boravišnu pristojbu i PDV, iskazane su po osobi na bazi noćenja s doručkom.. Jednokrevetna soba Dvokrevetna soba Hotel Ivan, Solaris, Šibenik 632,00 HRK 392,00 HRK Hotel Jakov, Solaris, Šibenik 477,00 HRK 302,00 HRK Ništa Smještaj nije potreban Datum dolaska → Note: Datum je u Dan.Mjesec.Godina formatu Datum odlaska ← Note: Datum je u Dan.Mjesec.Godina formatu Ukupno za platiti Plaćanje Odaberite vrstu plaćanja: Putem banke Kreditna kartica Plaćanje: Putem banke Podaci: Vlasnik računa: Conventus Credo d.o.o. IBAN: HR5324840081103726602 Raiffeisen bank Austria d.d. Zagreb, Petrinjska 59, 10 000 Zagreb, Croatia SWIFT: RZBHHR2X NAPOMENA: Kod svrhe uplate / opis plaćanja upisati ime i prezime sudionika. Kod poziva na broj upisati OIB sudionika (ako ste iz HR). Plaćanje: Kreditna kartica Vrsta kartice: Visa Mastercard American Express Diners Vlasnik kartice * Broj kartice * Datum isteka * CVC kod * Ovo polje ostavite prazno. Pošaljite registraciju Imate problema sa formom? Kontaktirajte nas putem anja@conventuscredo.hr