Speakers Logistics Form Brain Mets 2019

Title*

Dr.
Prof.
Mr.
Mrs.

Last name*

First name*

Date of birth*

Cell phone number*

Information mandatory in order to facilitate your transfer from and to the airport. Please do not forget to write your country dialling code (+33 ; +49 ; +212 ; etc.)

Email address*

ACCOMMODATION

Sofitel ***** Marseille Vieux-Port*

Night from October 3rd to 4th (night before the conference)
Night from October 4th to 5th
I don't need accommodation

The organizing committee has the pleasure to cover 2 nights.
The rooms are single rooms, with breakfast included.
If you need additional nights or a double room, thank you for specifying your needs below, in the "Special requests" field.
The additional nights will have to be paid on your own, directly to the hotel reception desk.

TRAVEL

Yes, I would like you to make my travel arrangements
No, I will make my own travel arrangements

Departure city*

Departure date*

Departure time*

Morning
Afternoon
Evening

Return city (if it is not departure city)

Return date*

Return time from Marseille*

Morning
Afternoon
Evening

Membership card type and number (airline, railroad company...)

Download your passport or ID Card*

Types de fichiers acceptés : jpeg, jpg, png, pdf, gif, Taille max. des fichiers : 128 MB.

Essential to book your travel. Thanks.

If you decide to make your own travel arrangements, thank you for sending your receipts and your mailing address or your bank details after the congress to :
Com & Co / BRAIN METS 2019
15 Bd Grawitz
13016 Marseille
Or by email to : e.jarry@comnco.com
We will proceed to your refund by bank transfer within 4 weeks, on a EUR 300.00 basis for France, EUR 500.00 basis for Europe or EUR 1 500.00 basis for International flights. If you use your personal vehicle, the allowances of refund will be calculated on a "Mappy" basis.

SOCIAL PROGRAM

Convivial Dinner on October, Thursday 3rd*

Yes, I would like to participate
No, I don't want to participate

Gala Dinner on October, Friday 4th*

Yes, I would like to participate
No, I don't want to participate

Miscellaneous

Special requests

Personal data*

By sending this form, I agree that my personal data might be used for the purposes of my logistic arrangements by the company or any service providers that may need it.

Name

Ce champ n’est utilisé qu’à des fins de validation et devrait rester inchangé.

Speakers Logistics Form Brain Mets 2019