REGISTRATION FORM & call for papers

Name:

Institution:

Address:

Phone:

Fax:

E-mail:
 

Registration Fee:

Please find enclosed a receipt of the Bank Transfer # ..................................... Date: .........................
Please charge my ................. Card # ............................................................ Expiry Date ...............
 

I would like to present a:
 
 

Talk (20 minutes)

Poster with short presentation (10 minutes)

(please underline)
 
Topic:

Session:

(Please include an Abstract of around 500 words)
 
 

Hotel preference:
 
 

(Please underline)

Other (please indicate):

(*) If you do not mind to share a room with a colleague, please indicate
       Sex:
       Any Name:

(**)  This is a Student University Residence. Prices are given on the basis of sharing a room between 2 or 3 persons, and the bathroom with various rooms. Any preference:
        Sex:
        Any Name:
        Sex:
        Any Name:
 
 

I would like to attend the excursion to:
 
 

A) Tenerife (½ day)

B) Tenerife (full day)

C) Gran Canaria

 
 

Accompanying person:
 
 
 

Yes

Maybe

No

(Please Underline)
 

Date and Signature: