Registration Form

Please fill in the following Registration Form:

SECTION 1: PERSONAL DETAILS

Title

Family Name*

Given Name*

IEEE MEMBER #

Organization*

Position

Personal Address*

Postcode*

City*

State

Country*

Fiscal code / VAT ID / Tax ID

Mandatory field for Portuguese companies

Place of birth / Town and Country*

Date of birth*

Use DD/MM/YYYY format

Phone*

Mobile

E-mail*

Special Disability / Dietary Requirements

UE GDPR 2017/679 - Data protection
The information collected during registration is subject to data processing to process your purchase and manage the congress and related social events. Without this information, we will be unable to properly process your registration. Your personal data will be processed in compliance with the UE GDPR 2016/679 and will be used for circulation within the company for administrative and counting activities. The data may be transmitted to external bodies which perform functions strictly connected and instrumental to service operations. In accordance with the chapter 3 of the European Regulation 2016/679 with regards to data protection, you have the right to request from SELENE Srl, access to and rectification or erasure of your personal data or restriction of processing concerning your data or to object to processing as well as the right to data portability. For such, please contact: [email protected]

I permit the use of my personal data for any purpose related to the Congress organization (in compliance with UE GDPR 2016/679).

* Data are required