Register as a speaker in FIRST INTERCONTINENTAL EXTRATERRITORIAL CONGRESS «PLANET OF PSYCHOTHERAPY» Children. Family. Society. Future.

Name, surname *

Place(s) of employment and current position(s) *

Academic titles and degrees (if any)

Professional memberships

Country, city *

Web-site

Mobile phone number *

E-mail *

Proof of payment *

Abstract title, full name and regalia of the speaker(s) (including country and city of residence), abstract summary for the Congress program (up to 750 characters including spaces, in strict accordance with the following example) *

Preferred session *

I hereby give my consent to process my personal data and to any actions (operations) performed with my personal data including collection, record, classification, accumulation, storage, revision, extraction, usage of data, transferring, depersonalization, blocking, deletion, termination of personal data with the use of automation facilities and without the use of automation facilities.

I hereby give my consent to audio and video recording and live broadcasting through web streaming at the Congress events.

Note: If you do not agree with your image or voice being recorded and published, we may inform you about recorded/broadcasted sessions, so you can avoid them, or, if possible, may offer you a designated part of the meeting room where there is no filming.

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