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8th - 12th November 2021
 
First name*
Surname*
Gender*
female
male
Home institution, city, country*
Department at your institution*
Position*
Topic of your lecture*
Email address*
Mobile phone number (in case of organizational changes, optional)
Planned date of arrival*
Planned date of departure*
Do you wish to book a room at Hotel Garni?*
no
yes

More information on the website http://www.hotelvsb.cz/.

Special dietary restrictions and requirements (e.g. vegan, vegetarian, allergy)*
no
yes
Would you like to visit the Ostrava Planetarium on Thursday, 11 November?*
no
yes
Would you like to visit the Manufactory of the honey cakes Marlenka on Thursday, 11 November?*
no
yes
Please rewrite text from picture*

All fields marked with an asterisk (*) are mandatory.