Registration form – XXIII International Congress of the Polish Cardiac Society

Personal data

Address for correspondence

Invoice details

(In case of leaving empty fields, a personal invoice will be automatically issued. Proforma and FV (after payment) are sent in PDF to the e-mail address provided in the form.)

The fee for full participation in the Congress includes a subscription of Kardiologia Polska for 2019 subject to voluntary consent below.

Voluntary consent

Please put “X” next to the chosen answer. Please tick “YES” to give your consent. If you do not tick any field or you tick “NO” it shall mean no consent. Giving consent is voluntary; consent can be withdrawn at any time free of charge. The withdrawal of consent shall not affect the lawfulness of processing carried out on the basis of the consent prior to its withdrawal. 

Further to art. 6 par. 1a of the EU Parliament and Council Regulation 2016/679 of 27 April 2016 on the personal data processing protection, free data movement and the repeal of Directive 95/46/EC (General Data Protection Regulation) ("RODO") I declare that I voluntary express my consent to have my personal data processed by Polish Cardiac Society ("Administrator") in Warsaw at ul. Stawki 3a lok.1-2, 00-193 Warszawa or at the request of the Administrator by entities cooperating with him in the necessary scope for purposes related to the subscription of the journal Kardiologia Polska ("KP").

I also declare that I have been informed pursuant to art. 7 par. 3 RODO that I am entitled to the withdrawal of consent at any time. The request for consent was presented to me in a clear and understandable form and I was informed about the condition of its accountability. I have also been informed that data is collected by or on behalf of PTK and about the purpose of their collection, the processing, the nature of the processing requirement and the consequences of not providing it, processing time, voluntary application, the right of inspection and the possibility of correcting them and that these data will be made available only to other entities providing external services to PTK to the extent necessary for the implementation of these services (eg entities providing publishing, consulting, IT, legal, accounting and auditing services). In addition, I was informed that in case of non-compliant processing, I am entitled to complaint to the supervisory body, which is from 25 May 2018 the President of the Office for Personal Data Protection.


Sum: 0 PLN