Sign up form for 5th International Student Conference Name * Surname * E-mail * Professional title * Academic title * Affiliation * Name of workplace * Job title * Name of the university * During the conference I will use the following language: * Topic of the speech / paper / presentation * Topic of article to publish * Publishing language * I declare that I'm exempt from conference fee as * PSW Student Partnered university student Student Teacher PSW Employee PSW partner as part of institutional cooperation PSW Senate Member Member of PSW Employer counsel Representative of the Conference Patron Exempt by the Organizer's decision I'm not exempt I would like to receive * Free participation certificate Credits points by industry rules on participation certificate *nie dotyczy słuchaczy Disability Certificate * I'm not a disabled person I am a person with a disability: Movement I am a person with a disability: Hearing I am a person with a disability: Deaf-blind Different Disability If you chose different disability As disabled persona I need help from organizer in terms of: *CONSENT TO THE COLLECTION, PROCESSING AND TRANSFER OF MY PERSONAL DATA: * I Agree **CONSENT FOR GRATUITOUS DISTRIBUTION: I Agree *** MARKETING CONSENT: I agree **** RODO INFORMATION: * I understand and agree with information about RODO Sending the application form means willingness to participate in the conference and a declaration of payment of the required conference fee, if the application does not concern a person exempt from its payment. The conference fee paid is not refundable in the event of withdrawal of the Participant from the conference or in the absence of sending the text for publication by 30.04.2023. * I understand and agree with above text Sing Up Website