2. Kongres hrvatske komore zdravstvenih radnika strukovnog razreda za medicinsko laboratorijsku djelatnost Medicinsko-laboratorijska dijagnostika u praksi 2ND CONGRESS OF CROATIAN CHAMBER OF HEALTH PROFESSIONALS PROFESSIONAL DEPARTMENT FOR MEDICAL LABORATORY ACTIVITIES MEDICAL LABORATORY DIAGNOSTICS IN PRACTICE 29.05. - 01.06.2014. Zagreb, Hotel Esplanade Zagreb PRIJAVA SUDJELOVANJA / REGISTRATION Prezime . ..............................................................................Ime...................................................................Titula............................................................... Last name First name Title Ustanova i adresa.................................................................................................................................................................................................................. Institution and Address Grad i poštanski broj................................................................................ Država................................................................................................................. City, Postal Code Country Osoba u pratnji (ime i prezime)............................................................................................................................................................................................. Accompanying person (first and last name) Telefon...........................................................................................................GSM................................................................................................................. e-mail............................................................................................................Faks................................................................................................................. JMBG...........................................................................................................ili OIB................................................................................................................. (Only Croatian participants) Kotizacija / Registration Fee • Rana kotizacija do 01.04.2014 • Kasna kotizacija nakon 01.04.2014 • Sponzorsko osoblje • Osobe u pratnji • Studenti i umirovljenici Early registration fee Late registration fee Sponsor staff fee Accompanying person fee Students and Retirees fee 1.500 kuna / 200 EUR 1.800 kuna / 240 EUR 1.100 kuna / 147 EUR 1.100 kuna / 147 EUR 750 kuna / 100 EUR Kotizacija za sudionike i umirovljenike uključuje / Participants and Retirees registration fee: sudjelovanje u znanstvenom programu, pristup izložbenom prostoru, materijale Kongresa, prisustvovanje svečanom otvorenju s koktelom dobrodošlice, kavu u stankama, ručak 30.05. i ručak 31.05. razgled grada Zagreba 30.05., svečanu večeru, bodove HKZR-a. / access to all Congress Sessions, Poster Sessions and Exhibition area, Congress materials, Opening ceremony and Welcome drink, Coffee breaks, Lunch on the May 30th and 31st 2014, Zagreb sightseeing tour on the May 30th, Gala dinner, credits of Croatian Chamber of Health Professionals. Kotizacija za sponzore uključuje / Sponsors fee: sudjelovanje u znanstvenom programu, pristup izložbenom prostoru, prisustvovanje svečanom otvorenju s koktelom dobrodošlice, kavu u stankama, ručak 30.05. i ručak 31.05. razgled grada Zagreba 30.05. i svečanu večeru. / access to all Congress Sessions, Poster Sessions and Exhibition area, Opening ceremony and Welcome drink, Coffee breaks, Lunch on the May 30th and 31st 2014, Zagreb sightseeing tour on the May 30th, Gala dinner. Kotizacija za studente uključuje / Students fee: sudjelovanje u znanstvenom programu, pristup izložbenom prostoru, prisustvovanje svečanom otvorenju s koktelom dobrodošlice, kavu u stankama, ručak 30.05. i ručak 31.05. /access to all Congress Sessions, Poster Sessions and Exhibition area, Opening ceremony and Welcome drink, Coffee breaks, Lunch on the May 30th and 31st 2014. Kotizacija za osobe u pratnji uključuje / Accompanying persons fee: prisustvovanje svečanom otvorenju s koktelom dobrodošlice, kavu u stankama, ručak 30.05. i ručak 31.05. razgled grada Zagreba 30.05. i svečanu večeru. / Opening ceremony and Welcome drink, Coffee breaks, Lunch on the May 30th and 31st 2014, Zagreb sightseeing tour on the May 30th, Gala dinner. Društveni program i izlet / Social Program and Excursion MOLIMO OZNAČITE NA KOJIM DOGAĐANJIMA ŽELITE PRISUSTVOVATI / PLEASE MARK WHICH EVENT DO YOU WANT TO ATTEND Koktel dobrodošlice 29.05. Welcome Drink May 29th Svečana večera 31.05. Izlet u Hrvatsko zagorje 01.06. ❏ NE ❏ DA Gala dinner May 31 ❏ NE ❏ DA Excursion to Hrvatsko zagorje June 1st 300 kn / 40 eur st pax............................... pax............................... pax............................... Razgled grada Zagreba 30.05.2014/ Zagreb city tour May 30th Molimo Vas da odaberete grupu s kojom želite razgledati Zagreb / Please select one option for Zagreb city tour you want to attend Puteni Zagreb The Sensual Zagreb ❏ NE ❏ DA pax............................... Klasični razgled Zagreba The Classic Zagreb Tour ❏ NE ❏ DA pax............................... Vještičje kolo The Witches’ Wheel ❏ NE ❏ DA pax............................... Otkazivanje sudjelovanje / Cancellation and Refund Policy Povrat uplaćene kotizacije do 15. ožujka, 2014.. umanjene za PDV i 30% troškova moguć je samo na temelju pismenog dogovora s organizatorom kongresa. Povrat sredstava biti će izvršen nakon završetka kongresa. Kotizacija neće biti vraćena ukoliko otkaz sudjelovanja nastupi nakon 15. ožujka, 2014. / The refunds (less PDV and 30% administrative expenses) will be granted to participants unable to attend if cancelled until March 15th, 2014. A written notice must be received by the PCO before March 15th, 2014. No refunds will be made for cancellations received after that date. All refunds will be issued after the Congress. 2. Kongres hrvatske komore zdravstvenih radnika strukovnog razreda za medicinsko laboratorijsku djelatnost Medicinsko-laboratorijska dijagnostika u praksi 2ND CONGRESS OF CROATIAN CHAMBER OF HEALTH PROFESSIONALS PROFESSIONAL DEPARTMENT FOR MEDICAL LABORATORY ACTIVITIES MEDICAL LABORATORY DIAGNOSTICS IN PRACTICE 29.05. - 01.06.2014. Zagreb, Hotel Esplanade Zagreb PRIJAVA HOTELSKOG SMJEŠTAJ / HOTEL ACCOMMODATION Za sudionike kongresa osigurane su posebne cijene smještaja. Molimo Vas da Vaš smještaj rezervirate najkasnije do 01. svibnja 2014. We have ensured special rates in following hotels to Congress participants. / Please book your accommodation no later than May 1st, 2014. CIJENA PO OSOBI/DAN / PRICE PER PERSON/DAY 1/1 soba - 1/1 Room 960,00 kn / 126 EUR 730,00 kn / 96 EUR 460,00 kn / 61 EUR HOTEL • Hotel Esplanade Zagreb 5* • Hotel Palace 4* • Hotel Central 3* 1/2 soba - 1/2 Room 550,00 kn / 72 EUR 430,00 kn / 56 EUR 310,00 kn / 41 EUR Cijena smještaja uključuje: noćenje s doručkom i boravišnu pristojbu. / Accommodation price include: stay tax, bed and breakfast datum dolaska / check in. ................................................................ datum odlaska / check out........................................................................................ Ukoliko ste odabrali dvokrevetnu sobu, lijepo Vas molim da navedete ime osobe s kojom ćete dijeliti sobu. / If you are staying in a double room please specify the name of the person you are sharing the room with: .............................................................................................................................................................................................................................................. Otkazivanje smještaja / Accommodation Cancellation Policy Ukoliko dođe do otkaza smještaja zaračunavaju se otkazni troškovi prema uvjetima hotela. Smještaj se potvrđuje prema redoslijedu zaprimanja prijava. NAPOMENA: Ljubazno Vas molimo da uplatite puni iznos troškova boravka u hotelu prije početka Kongresa. U suprotnom će Vam rezervacija biti otkazana. Booking cancellations will be charged according to the hotel policy. Accommodation will be confirmed according to applications receipt. NOTE: We kindly ask you to pay the full amount of the hotel cost before the beginning of the Congress otherwise your booking will be cancelled. NALOG ZA PLAĆANJE / PAYMENT ORDER Sudionici koji imaju kunski bankovni račun vrše uplatu u kunama, a ostali sudionici vrše uplatu u eurima. Uplata mora biti primljena prije početka kongresa. Za devizne i kunske uplate: Molimo platite u korist conTres projekti d.o.o. RAIFFEISENBANK AUSTRIA d.d., Petrinjska 59, Zagreb. IBAN: HR7924840081105269210, SWIFT: RZBHHR2X Obavezno navesti ime sudionika na uplatnicu. Uplatitelj mora pokriti sve bankovne troškove ili će mu isti biti naplaćeni na licu mjesta u stvarnom iznosu + PDV. Svrha plaćanja: HKZR The participants disposing of a bank account in Kunas shall make payment in Kunas, and others shall make it in EUR. The payment shall be received prior to the beginning of Congress. Bank transfer payment instructions (EUR): BENEFICIARY: conTres projekti d.o.o. BANK: RAIFFEISENBANK AUSTRIA d.d., Petrinjska 59, Zagreb. IBAN: HR7924840081105269210, SWIFT: RZBHHR2X The name of participant shall be stated on the payment slip. All bank transfer costs must be covered by the payee, otherwise you will be charged for them on site plus VAT. Purpose of payment:HKZR NAPOMENA: Sve promjene nakon potvrđene rezervacije se naplaćuju 150,00 + PDV NOTE: All changes after registration will be charged 20 eur + PDV PLATITELJ / payer - SPONZOR / sponsor Ustanova / ime i prezime / Institution / First and Last Name............................................................................................................................................. Adresa / Address................................................................................................................................................................................................................... OIB (Only Croatian participants)........................................................................................................................................................................................... Potpis / Signature. ................................................................................................. Datum / Date......................................................................................... Molimo ispunite prijavni obrazac u potpunosti i pošaljite ga na slijedeću adresu ili broj faksa Please fill out the registration form and send it to the following address or fax: conTres projekti d.o.o., Crvenog križa 11, 10000 Zagreb,Tel: +385 1 4821 193 Fax: +385 1 3700 495, e-mail: [email protected], [email protected]; www.contres.hr
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