Payment through Purchase Order / Bon de Commande

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Please fill this form ONLY if you wish to make payment through a Purchase order / Bon de Commande.
How it works:
1. On submitting the following form, we will send a devis/invoice to the person in charge of handling payments in your lab (details of which are collected through the following form)
2. The above person in charge then sends us a Bon de commande / Purchase Order.
3. Once we receive the Bon de commande from you lab, you will receive the link for abstract submission (along with proof of payment)

First name *

Last name *

Email address *

Institute / University *

Current position *

Master student

PhD student

Post-doc

Others

Participation type: *

Attendance only

Poster presentation

Do you belong to a YRLS partner association? *

ACTIF

ADIC

APINEM

Doc'J

IDPA

Les Cartesiens

SPIBENS

STAPA

Y2RI

None of the above

In case you belong to any of the above partner associations, you are eligible for a discount. Please contact your association for the reduction code and enter it below:

Photo consent: *

I consent to be photographed during the conference and for the pictures to be used for future YRLS communication (if needed)

I do not wish to be photographed during the conference

Email address of the person-in-charge of payments in your lab (usually a secretary): *

Name and Address of your lab (for adresse de facturation. Please include the INSERM or CNRS affliation of your lab if applicable. eg: UMRxxxx or Uxxxx): *

Do you have any food preferences? *

Vegan

Vegetarian

None

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