Personal Details
Last name
First name
Telephone (inc country code)
Mobile (In country code)
Preffered Language
Dietary Requirements (If any)
Other needs (Including mobility needs)
Emergency Contact Name
Emergency Contact number (inc. country code)
Emergency Contact email
Relationship to emergency contact (optional)
Do you require a visa to enter Ukraine?
Only for those who need a visa
Do you require any transit visas (please specify for which country if applicable)
Passport Number, Date of Birth, Date of Issue, Place of Issue, Date of Expiry, Nationality
Select the most accurate arrival time as possible
Date of arrival
Time of arrival
flight / train number
Select the most accurate departure time as possible
Date of departure
time of departure
flight / train number
Accompany person
Last name
First Name
Dietary requirements
Pen Centre
PEN Centre / Organisation
Centre Dues
Is you Centre up to date with their Centre dues?
Registration Fee
accompany person - 150 EUR ( 4500 UAH)
Rooms can be booked on the hotel website using promo code PENCON2017
to book a room in the hotel, please click here
do you want to share with another delegate or another person?
Passport number of another delegate\another person
Name of the delegate\another person
Optional Excursions
Please, choose excursions which you would like to attend (23 or 24 of September).
Payment after arrival
Other comments
Some of the required blanks are not filled or filled in wrongly.
Thank you for your registration.
You will receive further information regarding programme and logistics soon.
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