Registration for Banja Luka Events, October 4th - 8th 2021 - Short course and Workshop #5

Surname

Name

Email Address

Affiliation

I am a I am a ESR PI PO representative AB members Other

Which days will you attend ? Which days will you attend ? Short course 5 Day 1 (Monday 4th October) - restricted to ESRs Short course 5 Day 2 (Tuesday 5th October) - restricted to ESRs Day trip to Tuzla (Wednesday 6th October) Workshop 5 Day 1 (Thursday 7th October) Workshop 5 Day 2 (Friday 8th October)

Do you want to attend the workshop: Do you want to attend the workshop: Online On site

Do you want to introduce a talk during the workshop (mandatory for ESR) ? If yes specify title and preferred day

Will you participate to the Gala dinner on Thursday 7th October ? Will you participate to the Gala dinner on Thursday 7th October ? Yes No

Dietary restrictions Dietary restrictions None Vegetarian Vegan Kosher Halal Gluten-free Others

Do you want to stay at hotel Vidovic (54e single room / 72e double room) ? Hotel Vidovic is located at Ul. Ivana Franje Jukića 11in Banja Luka. The Short Course and workshop will take place in Hotel Vidovic Congress Hall. If you want to stay at Hotel Vidovic please indicate day of arrival and departure + type of room selected.

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