Registration Form


Attention! All fields must be filled in English. Fields marked with an asterisk (*) are required.
 
Personal Data:
First name*
Last Name*
Company or Institution you represent(*)*
Position(*)*
E-mail*
Phone.*
If you are a student, please insert name of your university/college in the “Company or Institution you represent” box, and “student” or “doctoral student” in the “Position” box.
Students are offered a 50% discount. Please send us a scan of your valid student ID card before carrying out your payment to e-mail: konferencjaet@neurodevice.pl
Please issue me an invoice for the participation fee.
* I agree to the terms of participation in the 5th Polish Eye Tracking Conference and I grant permission for processing my personal data included in this registration form only for the purposes of registration for Conference.
I grant permission for the Organizers of the 5th Polish Eye Tracking Conference to use my images for marketing and promotions and
If you want to be up-to-date with the next editions of Polish Eyetracking Conference and related events, receive information materials – that is enable us to contact you after the conference, please chech the box below:
I hereby agree to receive corporate information from Neuro Device Group S.A., 1 Plowiecka St., 04-501 Warsaw, Poland, pursuant to the law of July 18, 2002 on services provided by electronic means (Dziennik Ustaw journal of laws No. 144 of 2002, item 1204 as amended). Personal data will be processed for marketing purposes.

The personal data administrator is Neuro Device Group S.A., 1 Plowiecka St,. 04-501 Warsaw, Poland. Personal data will be processed only in marketing and statistical puposes. Personal data are for Neuro Device Group S.A. or data administrators appointed by Neuro Device Group S.A. use only. Pursuant to the law of 29 August 1997 on personal data protection (Journal of 2002, No 101, sec. 926 as amended), you have the full right to inspect and change your personal data. Gathering your personal data happens on a voluntary basis.

 
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