Observational Cosmology with the New Radio Surveys, Registration Form

OBSERVATIONAL COSMOLOGY

WITH

THE NEW RADIO SURVEYS

Puerto de la Cruz, Tenerife, Canary Islands

Spain

13-15 January 1997

Registration Form

PLEASE FILL IN THIS FORM AND SUBMIT IT TO US BEFORE DECEMBER 10TH BY CLICKING ON THE FOLLOWING BUTTON:

You can also retrieve the ASCII version of the registration form and send it by e-mail to cosmowrk@iac.es.

The registration fee is 20,000 Pesetas to be paid by bank transfer to:

Bank name: Banco de Bilbao Vizcaya
Bank address:

C/ Obispo Rey Redondo, 25

E-38201 La Laguna, Tenerife

Spain

Full account number: 0182 0772 45 0000 134741
Bank: 0182
Branch: 0772
Sorting code: 45
Account number: 0000 134741
Please quote your name and the following reference with your bank transfer:
Cosmology Workshop

First Name ..... : 
Last Name ...... : 
Title .......... : 
Institute ...... : 
Street/PO Box .. : 
City ........... : 
Postal Code .... : 
Country ........ : 
Telephone ...... : 
Telefax ........ : 
E-Mail ......... :

I would like to:: Present a paper on:
Paper Title:
Oral presentation preferred.
Poster preferred.
No preference.

Are you interested in the full day excursion to La Palma on Thursday, January 16th?
Yes
No

If you have any comments or special needs, please indicate them in the space provided below:

If you like, you can submit an abstract now by typing it in the space provided below. Otherwise, you can do that at a later time, by using the Abstract Only Form. The latter should be used also if you have more than one abstract to submit.

For further assistance, you can contact us at the following address:

CONTACT ADDRESS:

Monica Murphy (Workshop on Observational Cosmology with the New Radio Surveys)
Instituto de Astrofisica de Canarias
C/ Via Lactea s/n
E-38200 La Laguna, Tenerife
SPAIN
Tel: + 34 22 605261
Fax: + 34 22 605210
e-mail: cosmowrk@iac.es
WWW URL address: http://www.iac.es/cosmowrk/
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