APV- REG-2024

Please fill out the form in English only

Personal Information

* Given Name

* Last Name

* Position

* Company

* ID number / Passport number

* Mobile

* Email Address

I approve sending verifications, instructions, and other messages to the email address and phone number I have provided.

Tickets

* Event Ticket

Single Day Ticket - 315₪ (approximately 85$)

Two- Day Ticket - 449₪ (approximately 120$)

* Choose a Day

Tuesday 5.3.24

Wednesday 6.3.24

Payment

We do not accept American Express or Dinners

Item	Subtotal
Subtotal	Subtotal	₪
Discount
Total	Total	₪

If you have a code - enter it here

Apply Code

Total Amount

0.00 ₪

* Payment Method

I agree to make out a check

After submitting the form you will be redirected to a secure website to perform the transaction. Only after doing so will your registration be completed.

Invoice/Receipt Information

* Email address for invoice/receipt

* Name for invoice/receipt

* Institute Name

* Institute Number

* Institute's accounting contact

* Institute's accounting phone

* Institute's billing address

I agree to make a bank transfer of the aforementioned amount

After submitting the form you will be redirected to PayPal to confirm the transaction. Only after doing so will your registration be completed.

Invitation code

In order to verify that you were invited, please fill in the code you recieved when invited

We do not accept American Express or Dinners