                          OBSERVATIONAL COSMOLOGY

                                    WITH

                           THE NEW RADIO SURVEYS

                Puerto de la Cruz, Tenerife, Canary Islands

                                   Spain

                             13-15 January 1997


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Registration Form
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PLEASE FILL IN THIS FORM AND SUBMIT IT TO US BEFORE DECEMBER 15TH TO
 cosmowrk@iac.es

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

Bank name: 
	Banco 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

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

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I would like to (delete or mark as aplicable):
      Present a paper on:
     		Paper Title:
      ___ Oral presentation preferred.
      ___ Poster preferred.
      ___ No preference.

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Are you interested in the full day excursion to La Palma on Thursday,
January 16th? (delete as applicable)
 				     Yes
 				     No
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If you have any comments or special needs, please indicate them in the space
provided below:








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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 (http://www.iac.es/cosmowrk/absform.html). The latter 
should be used also if you have more than one abstract to submit.
Please be reminded that all abstracts must be submitted by December 20th.


Abstract: 






















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CONTACT ADDRESS:

For further assistance, you can contact us at the following 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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