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Prihlaska prezentace * Speaker Proposal Form 2009

Page history last edited by Jarda 11 years, 5 months ago

Kutná Hora One–Day Conference*Seminars *  Friday 30 January 2009

 

 

ALTERNATIVES

Accredited by the Ministry of Education * Akce je akreditována MŠMT ČR

č.j. 10694/2006-25-122

 

Under the auspices of the Mayor of Kutná Hora * Pod záštitou starosty města Kutná Hora

 

přihláška prezentacE / Speakers proposal form

 

 

Prosím vyplňte také základní přihlášku/ fill in also the registration form, please

 

 

Příjmení / Surname: .....................................   Jméno / First Names: ...............................................

(paní, pan, slečna, Mr, Mrs, Ms, Miss, Mgr., Dr., Ing., ...)

 

 

Adresa/address:........................................................................................................................................................................................................................................................................................

Telefonní/Faxové číslo/Tel./Fax: ............................... e-mail:...........................................................

 

 

Type of Presentation: (Please indicate your choice)

1. Talk (20, 30, 45 min)  2. Workshop ( 20, 30, 45, 60 min)  3. Poster  4 Other (please specify)

………………………………………………………………………………………..…….......

Target Audience (Please indicate): primary, lower-secondary, upper-secondary, tertiary 

If your contribution is on behalf of a publisher, give more details here.

 

 

Summary of Presentation (in both Czech and English, please). Max. 100 words per each language.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Equipment Requirements (Please indicate):

 (  ) video replay equipment      (  ) cassette recorder    (  ) dataprojector   (  ) OHP   (  ) other (please specify) : ............................................................................................................................................

Please note that provision of other specified equipment will be subject to availability. There is either dataprojector or computers in different rooms available.

There are plans to publish Proceedings of the Conference; further details of the format for those wishing to submit their contributions will be provided later.

 

 

Úhradu konferenčního poplatku proveďte / Payment to be made to:

na účet asociace: AUA CR – Praha 1, Česká spořitelna, Václavské nám.

číslo účtu / account number: 1923416359/0800

variabilní symbol / variable symbol: 30012009

Přihlášku s kopií dokladu o úhradě konferenčního poplatku vraťte na adresu / Your registration will not be processed until payment has been received. Please enclose a copy of your proof of payment. Cancellations received before 15th December 2008 will incur a 50% cancellation charge. Cancellations received after 15th December 2008   will not be refunded.

do 30. září 2008 / Please return this form by 30 September 2008

Ms. Jana Jilkova, Regionalni centrum AUA ČR, ICV, Ostašova 524, 284 01 Kutná Hora

e-mail: icvkh@tiscali.cz, auakh.icv@gmail.com

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