CONTACT DETAILS

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    *Surname

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    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
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    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 2022 Name Surname"

    DATA PROCESSING AGREEMENT

    * I authorize PSIP to issue the invoice without the recipient's signature

    *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 4th International Conference "Integration of Psychotherapy: Research, Experiences, Perspectives" (June 3-5, 2022) for the purpose and scope necessary to realize my passive participation in this conference.
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    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 4th International Conference "Integration of Psychotherapy: Research, Experiments, Perspectives" (June 3-5, 2022) in order to inform me electronically about events organized by PSIP

    You can change or withdraw your consent at any time in accordance with the rules described in the Privacy Policy.