INTERNATIONAL CONFERENCE

ON FUNCTIONAL NANOMATERIALS AND NANODEVICES

24-27 September 2017, Budapest, Hungary

REGISTRATION FORM

REGISTRATION INFORMATION: Please print all the information clearly. Since the information will be used to send the
Proceedings DVD, please ensure the accuracy of the mailing address.

Kokkinopoulou
Last name:________________________________ Maria
First name:___________________________________
maria.kokkinopoulou@outlook.com
E-mail: _____________________________________________________________________________________
Company or Institution: _______________________________________________________________________
Max Planck Institute for Polymer Research
Ackermannweg 10
Street: _____________________________________________________________________________________
Mainz
City: ____________________________________ State/Province:___________________________________
Country:_________________________________
Germany Zip/Postal code:__________________________________
55128
Telephone:_______________________________
004961313790 Fax:____________________________________________
00496131379100
___________________________________________________________________________________________

SYMPOSIUM REGISTRATION Before April After April

Registration fee includes proceedings 30th 30th

Speaker (I) Regular: 370 EUR x 400 EUR

Speaker (II) Invited: 350 EUR 350 EUR

Student: 350 EUR 380 EUR

One-Day registration: 150 EUR 200 EUR Mon Tue Wed

Type of attendance: x Oral Poster Attendance (without presentation)

The Conference Registration Fee includes attendance during the Sessions, a copy of the Program Book, and a participant badge. Also included
are lunches, welcome reception, gala dinner and refreshments during the morning and afternoon breaks.
Check the box below for your Method of Payment:

Direct bank transfer to the European Nanoscience and Nanotechnology Association:

Receiver: Sdruzhenie EANN/ Address: Triaditsa, str. Tsar Asen 80, app. 1, Sofia 1000, Bulgaria
Bank: Raiffeisenbank (Bulgaria) EAD, Square St. Nedelja 5, Sofia 1000, Bulgaria
BIC: RZBBBGSF IBAN: BG47RZBB91551006217377 With reference to Nanomat2017 and Registrants Name

Pay-Pal transfer to the following address: sales@europenanoscience.org

With Debit or Credit card (using the Paypal Platform without having a Pay-pal account):
x use the following address: sales@europenanoscience.org

___________________________________________________________________________________________
State dietary restrictions, if any:

Vegetarian No shellfish Gluten-free No alcohol

Vegan No nuts Lactose-intolerant Extra alcohol

European Nanoscience and Nanotechnology Association

Address: 111 Rakovski Str, 1000 Sofia, Bulgaria
E-mail: info@europenanoscience.org
Tel: +359895792567