Registration Form Sample

Personal Information

Data protection agreement (required)
Your agreement is required in order to process your registration. Your contact details are held in a secure manner for the purposes of Abreu Events conference administration.

Please indicate YES to proceed with your registration*

* Mandatory fields

Title

Name *

Surname *

Institution

Address

Postal Code

City

Country *

Phone

Email *

Username *

Password *

(Please create a Username and a Password so you can later edit your booking)

I agree to the information on this form being stored in an electronic format by Abreu Events for the purposes of Abreu Events congress administration. *

Data for Billing Receipt/Invoice Copy Data

The following information is going to be printed in the receipt/invoice. This information cannot be changed after the receipt has been issued. Please verify if all the details are correct.

Name *

Address *

Postal Code *

City *

Country *

VAT Number *

VAT Number: If not applicable insert 999999990.

Registration

	Unit Value	Quantity	Total Value
Registration *
Student	€ 200.00
Please attach the student document proof (maximum file size: 700 Kb) *

Speaker	€ 100.00

Professional	€ 600.00

Press	€ 3.00

Additional Services

	Unit Value	Quantity	Total Value
Social Programme
Conference Dinner	€ 100.00
Dietary Restrictions

Cocktail	€ 50.00

Accompanying persons

* Mandatory fields

Number of Accompanying persons

Accompanying person Information

Title

First Name and
Last Name *

Accompanying person Registration

	Unit Value	Quantity	Total Value
Registration *
Accompanying person	€ 100.00

Accompanying persons Additional Services

	Unit Value	Quantity	Total Value
Social Programme
Cocktail	€ 50.00

Accommodation Reservation

Prices per Room and Night with Breakfast Included

Price per Night

Guest Name *

Checkin *

Checkout *

Total Price

Myriad by Sana Hotels *****

Single Room

€ 200.00

Double Room

€ 250.00

REGISTRATION FORM SAMPLE

Please choose an option: