3rd International Man-Food-Health Conference
Registration of participation in Conference
Personal data
Name and surname *
Title and academic or professional degree/students/doktorant student *
Position *
Institution *
Telephone number *
E- mail adress *
Additional notes (for example: one-day participation)
Data of represented Institution
Name of the Institution *
Full adress *
Post code, city *
Institiutions' telephone number *
Institiutions' e- mail adress *
Invoice details
Institutions' name
Full adress
Post code, city
The address to which the invoice is to be sent
Options of invoice' delivery
Title of the paper:
Form of the presentation (mark)
Please attach a abstract of the paper in English (maximum 500 words, please highlight the name of the referring person)
Bank account for payment (PLN - in polish zloty): 36 1020 5226 0000 6902 0571 8400 Transfer title: Man-Food-Health, name and surname of the participant.
The application is tantamount to consent to the processing of personal data for organizational purposes by the Medical University of Wroclaw. In accordance with the Act on the Protection of Personal Data (consolidated text, Journal of Laws of 2002, No. 101, item 926), the conference participant has the right to inspect their data, correct them and request to stop processing personal data
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