APPLICATION FORM - CONFERENCE "CONNECTED BY PEOPLE" organized by Wrocław University of Environmental and Life Sciences and the Department of Archeology, Faculty of Arts of the University of West Bohemia in Pilsen
Wrocław, 9-10 December 2022
1.	NAME AND SURNAME OF THE PARTICIPANT:	
2.	STATUS: student / PhD student *	
3.	NATURE OF PARTICIPATION: active / passive *	
3.	AFFILIATION / NAME OF THE UNIVERSITY / SCIENTIFIC CIRCLE:	
4.	FORM OF SPEECH: presentation / poster / not applicable *	
5.	WILL I NEED AN INVOICE?: YES / NO *	
6.	INVOICE DETAILS:  name, surname and address of the person making the payment
(if the paying person wants the invoice to be issued to the university, it must meet the condition contained in the message)

	
7.	I AGREE TO SEND THE INVOICE TO THE E-MAIL ADDRESS:
	
* mark the correct answer

  In the case of active participation, it is necessary to send an abstract!

The conference fee includes:
• costs of conference materials
• 2 x lunch
• coffee breaks
• participation in an integration party
GDPR information CLAUSE
1. Pursuant to Art. 13 sec. 1 and sec. 2 of the General European Data Protection Regulation of 27 April 2016, hereinafter referred to as the GDPR, we would like to inform you that:
The administrator of personal data is the Wrocław University of Environmental and Life Sciences with its seat at C. K. Norwida 25, 50-375 Wrocław, NIP: 896-000-53-54, REGON: 000001867.
2. The Wrocław University of Environmental and Life Sciences has appointed a Data Protection Officer (DPO), who can be contacted at the following e-mail address: iod@upwr.edu.pl
3. Personal data will be processed in order to register participation in the Conference "Connected by people" organized on December 9-10, 2022.
by the University of Life Sciences in Wrocław, to communicate in connection with the organization of the conference / project and to document its course.
Personal data will be processed in accordance with art. 6 sec. 1 lit. c, GDPR on the basis of the Law on Higher Education and Science of July 20, 2018. (Journal of Laws of 2022, item 574, as amended).
4. Personal data will be processed until the expiry of all contractual obligations or until the rights and obligations under the law expire.
5. You have the right to access your data and the right to rectify it, limit processing, the right to transfer data, the right to object to data processing. In order to exercise your rights, please contact the IOD of the Wrocław University of Environemntal Life Science, at the 
iod@upwr.edu.pl.
6. Personal data will not be subject to automated decision-making and profiling processes and will not be transferred to third countries (to a country outside the European Economic Area - EEA).
7. There is a right to lodge a complaint with the President of the Data Protection Office.

Date and signature………………………………………………………