Rektor agh

The First International Conference Scientific-Research Cooperation between Vietnam and Poland

Application form for The First International Conference

“Scientific-Research Cooperation between Vietnam and Poland”

AGH University of Science and Technology in Kraków, Poland, 23^rd to 27^th of June 2014.

The application should be sent via e-mail or fax to the date of 31^st of March 2014.

email: [e-mail], fax. [phone]

Information about the Participant:

Participant’s name and surname
Participant’s position
Institution/Firm
Address
City, postal code
Telephone number
Fax number
E-mail address

Participation fee in amount of 300 PLN should be paid to the date of 2^nd of June 20014 to the bank account number which will be provided in April.

Transfer title: Conference/Participant’s name and surname.

Additional comments ……………………………………………………………………………………….……………………………………………

………………………………………………………………………………………………………….……………………………………………………………

Signature (seal):

AGH University of Science and Technology|Section for Cooperation

Department of International Relations

al. A. Mickiewicza 30, 30–059 Krakow,

tel. [phone], fax [phone]

e–mail: [e-mail], www.polviet.agh.edu.pl