Registration form CONTACT DETAILS *Name *Surname *Phone *Email Comments For psychotherapists forced to leave their country, we have prepared a pool of free invitations to the conference. If you want to use such an invitation, please send your application using this form DATA FOR INVOICE *Institution name *Address *Number *Zip code Vat code In order to confirm participation and book a place, please pay the conference fee according to Conference Fees. We would like to remind you that the amount of the payment depends on the date of payment into the account, and not the application itself. ADDRESS: The Polish Society for the Integration of Psychotherapy Katowicka 18, 03-932 Warsaw ACCOUNT NUMBER: BIC/SWIFT: ALBPPLPW IBAN: PL 21 2490 0005 0000 4600 5084 6963 Please enter the title of the transfer: "Warsaw Conference 2024 Name Surname" DATA PROCESSING AGREEMENT * I authorize PSIP to issue the invoice without the recipient's signature Yes *I consent to the processing by the Polish Society for the Integration of Psychotherapy (PSIP), Katowicka 18, 03-352 Warsaw, my personal data contained in the application form for participation in the 5th International Conference Psychotherapy relationships, that work" (June 14-16, 2024) for the purpose and scope necessary to realize my passive participation in this conference. * Yes I consent to the processing by the Polish Society for the Integration of Psychotherapy (PSIP), Katowicka 18, 03-352 Warsaw, my personal data contained in the application form for participation in the International Conference Psychotherapy relationships, that work" (June 14-16, 2024) in order to inform me electronically about events organized by PSIP Yes You can change or withdraw your consent at any time in accordance with the rules described in the Privacy Policy. protected by reCAPTCHA by GooglePrivacy Policy and Terms of Service
CONTACT DETAILS *Name *Surname *Phone *Email Comments For psychotherapists forced to leave their country, we have prepared a pool of free invitations to the conference. If you want to use such an invitation, please send your application using this form DATA FOR INVOICE *Institution name *Address *Number *Zip code Vat code In order to confirm participation and book a place, please pay the conference fee according to Conference Fees. We would like to remind you that the amount of the payment depends on the date of payment into the account, and not the application itself. ADDRESS: The Polish Society for the Integration of Psychotherapy Katowicka 18, 03-932 Warsaw ACCOUNT NUMBER: BIC/SWIFT: ALBPPLPW IBAN: PL 21 2490 0005 0000 4600 5084 6963 Please enter the title of the transfer: "Warsaw Conference 2024 Name Surname" DATA PROCESSING AGREEMENT * I authorize PSIP to issue the invoice without the recipient's signature Yes *I consent to the processing by the Polish Society for the Integration of Psychotherapy (PSIP), Katowicka 18, 03-352 Warsaw, my personal data contained in the application form for participation in the 5th International Conference Psychotherapy relationships, that work" (June 14-16, 2024) for the purpose and scope necessary to realize my passive participation in this conference. * Yes I consent to the processing by the Polish Society for the Integration of Psychotherapy (PSIP), Katowicka 18, 03-352 Warsaw, my personal data contained in the application form for participation in the International Conference Psychotherapy relationships, that work" (June 14-16, 2024) in order to inform me electronically about events organized by PSIP Yes You can change or withdraw your consent at any time in accordance with the rules described in the Privacy Policy. protected by reCAPTCHA by GooglePrivacy Policy and Terms of Service
