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DCIS 2022 REGISTRATION FORM

Registration Data

First Name*

Last Name*

Company / Affiliation*

Work Email Address*

Phone

Registration Type*

IEEE Member Number

(Note: Full-time students enrolled in a college or university, please, send proof of your student status to dcis2022@unavarra.es)

Authors

If you are an author registering papers, please list the 4 digit codes of up to four papers you co-authored (2 papers included in the registration fee)

4 digit code of 1st paper

4 digit code of 2nd paper

4 digit code of 3rd paper (100 € fee)

4 digit code of 4rd paper (100 € fee)

(Note: for more than 4 papers, please contact dcis2022@unavarra.es)

Accompanying person and dietary restrictions

Are you coming with an accompanying person?

Yes

Do you have any dietary restrictions?*

Additional comments

Invoice Data

Do you need an invoice?

Yes

Company:*

VAT Number:*

Address*

Postal Code:*

City:*

Country:*

Payment

Total Payment

€ (Euros)

Payment should be done by bank transfer to the bank account:
Account holder: Universidad Pública de Navarra
IBAN code: ES16 3008 0001 1807 0019 0523
SWIFT (BIC) code: BCOEESMM008
Bank: Caja Rural de Navarra
City: Pamplona (Spain)

Please include as description in the bank transfer: your last name - DCIS
Please send an email to dcis2022@unavarra.es including a PDF scanned copy of the bank transfer receipt.

Security code

Personal data contained in this form will be processed by the Public University of Navarra as responsible for data management. This management is justified by the consent of the interested party and by the purposes that justify the completion of the form, explained in the text of the form itself.
Data processing must be carried out in accordance with General Data Protection Regulation (EU) 2016/679 Organic Law 3/2018, of December 5, on Data Protection. The rights of the interested parties regarding access, rectification, deletion, limitation, opposition or others related to data protection may be exercised at delegado.protecciondatos@unavarra.es