eurostar-science - PhandTA 8, Registration

Registration Form

Not for payment by credit card !

First Name
Last Name
Company/Univ../ Address
Zip
Town
Country
Telephone
Fax
E-Mail


I will be accompanied by person(s).
Name(s)

I intend to present a Contribution Yes No
Title
Author(s)
Preferred presentation

I will join the Workshop on Thursday, September 30, 2004. Yes No
For details, please refer to the Workshop page.

I will organize my accomodation in Ascona on my own responsibility Yes

I would like to reserve at Monte Veritá a

Single Room

Double Room to share with

This form is intended for payment by bank transfer. Please be aware of, that all banking charges are on your own account.
If you would like to pay by credit card, please use the fax form provided.
Please pay the registration fee beforehand the conference. A bill including all details for payment will be sent within 3 weeks after receipt of your registration.

In case you would like to print out the form, please do it now before sending.

Conferences - PhandTA 8

Registration Form