Registration form

Personal data

Mrs * Mr * Ms *

First Name *

Family Name *

Company/Organisation

Address *

Post Code *

City *

Country *

Phone Number *

Email address *

Title of the paper *

Registration fee *

	Before 25.04.2008	After 25.04.2008
Individual/institutional member	190 €	230 €
Student	100 €	140 €

Attention!
For ESA-members registration fee come to 140 Euro (only if you register before 25.04). Completing registration form, please remember to give your ESA member's number (in field 'notes').

Food *
Non-vegetarian
Vegetarian

Notes

Conference fee should be paid on conference account:

Recipient: University of Lodz
Address: Narutowicza 65, 90-131 Lodz, Poland
NIP: 724-000-32-43
REGON: 000001287
Title of bank transfer: "Teaching of Qualitative Methods. Midterm in Lodz"
Account number: PKO S.A. II/O Lodz 14 1240 3028 1111 0010 0434 7782
SWIFT: PKOPPLPW

Conference Secretary Office
Contact person: Dominika Byczkowska
e-mail: Midterm-QN-ESA@soc-org.edu.pl