APPLICATION for UNICA 2014

For up to 2 delegates (for more than 2 people please make copies of the form) 	Please write in CAPITAL LETTERS!

I/We register for UNICA 2014 in Piešťany, SLOVAKIA:
Delegate 1	  Man      Woman	Delegate 1	  Man      Woman	
Family name:      	Family name:      	
First Name:      	First Name:      	
Street:      	Street:      	
Town / place:      	Town / place:      	
Country:      	Country:      	
Tel. Nr.:      	Tel. Nr.:      	
E-Mail:      	E-Mail:      	
Language:      English       German      French	Language:      English       German      French	

CONGRESS CARD:	Price 200.00 Euros	includes: Opening banquet, excursions, Closing banquet,
		share of the administration costs 
	***	This price is held until 01.06.2014
		After that date the price is 210.00 Euros for a Congress Card.
I/We order	     	Congress Card/s at		Euro 200.00	
or:	     	individual ticket:	Opening banquet	Euro 40.00	
	     	individual ticket:	1st Excursion	Euro 80.00	
	     	individual ticket:	2nd Excursion	Euro 45.00	
	     	individual ticket:	Closing banquet	Euro 45.00	
We ask you to transfer the price for your Congress Card/s or tickets to our bank in a way which cost us nothing.
Our Bank Account:
Sparkasse Hochrhein	DE-79761 Waldshut-Tiengen
SLOWAKEI	Kontonummer	77057883
	IBAN	DE79 6845 2290 0077 0578 83
	BLZ	684 522 90
	BIC	SKHRDE6W

Register: 	by Post: 	Zuzana Školudová, Národné osvetové centrum, Námestie SNP 12, 812 34 Bratislava, Slovakia
	by E-Mail: 	unica2014slovakia@gmail.com

	Signature

If you need transport from Bratislava to Piestany on 22 or 23 August 2014, please send a message with your name, and e-mail: unica2014slovakia@gmail.com  or by post to Zuzana Školudová, Národné osvetové centrum, Námestie SNP 12, 812 34 Bratislava, Slovakia. To reserve your seat on the bus. You will receive a reservation confirmation via e-mail.
The estimated price is € 10 per person and trip.
We also offer the same service for the return trip on 31 August 2014.

Each delegate must make his or her own hotel reservations directly with their hotel.