CONFERENCE REGISTRATION FORM

Please fill in the form below. All fields marked with an asterisk * are mandatory	.

1. PERSONAL DATA

* Last Name

* First Name

* Affiliation

* E-Mail

2. DETAILS FOR INVOICING (Please verify the accuracy of the data with your administration)

* Institution

* Department

* Street

* Zip/Postal Code

* City

State/ Province

* Country

* VAT/ Ust.-IdNr.

* Email for Invoicing

* If necessary, cost center / invoice identification number of your institute administration

3. REGISTRATION CATEGORY

4. DINNER REGISTRATION

Dietary Restrictions

You will receive an invoice and payment request (bank transfer only!) in a seperate e-mail.

4. GENERAL DATA PROTECTION REGULATIONS (GDPR)

Please agree to the following terms by checking the boxes:

In accordance with Art. 6 (1 a) GDPR, I hereby consent that my details (surname, first name, title, institution, place, country) be published in a list of participants, which shall be made available to all participants in the event.

In accordance with Art. 6 (1 a) GDPR, I hereby consent that, even after the event, my address details remain stored at the organizer (Leibniz-Institut für Polymerforschung Dresden e. V. - IPF) and be used by the IPF for sending information on future scientific events.

I hereby consent to the taking of photographs in the course of the conference and to the use thereof for the purposes of event-related public reporting and event documentation. This expressly includes my consent to the use and publication of my image (without remuneration and without any limitation as regards time, territory or content) in accordance with Section 22 KunstUrhG [Artistic Copyright Act] and Art. 7 GDPR.

For further information, please refer to our conference website:
https://lfv-ams.ipfdd.de/conferences

Please email this form to: vilbrandt@ipfdd.de