FIRST NAME

    LAST NAME

    PERSONAL IDENTIFICATION NUMBER (required for individuals)

    DATE OF BIRTH (Only for young scientist award)

    PROFESSION/SCIENTIFIC TITLE

    INSTITUTION

    UNIQUE IDENTIFICATION CODE (Required companies/institutions)

    TRADE REGISTER NUMBER (Required companies/institutions)

    ADDRESS

    TEL

    FAX

    EMAIL

    TYPE OF PRESENTATIoN

    [recaptcha]