REGISTRATION FORM

Name and surname:.......................................................................................................................... 

Institution / affiliation:....................................................................................................................

....................................................................................................................................................................

e-mail: ....................................................................................................................................................

I wish to attend the conference on 12 June:    YES/NO	on 13 June:  	YES/NO

I wish to attend the reception and award ceremony of the Prize of the Platform 

of European Memory and Conscience on 12 June: 	 YES/NO 

Accommodation is reserved for conference participants at Hotel Yasmin****, www.hotel-yasmin.cz, at a rate of 100,-  EUR / single or double room with breakfast. Booking is required by 29 May 2014. 

I wish to book my stay at Hotel Yasmin. Number of rooms: .........................

11/12 June 	YES/NO	12/13 June 	YES/NO 	13/14 June 	YES/NO

Please return this form to conference2014@memoryandconscience.eu .