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Registration form
(Fields marked with * are obligatory)
PERSONAL DATA
*First Name:
*Last Name:
*Sex:
female
male
*Institution:
MAILING ADDRESS
*Street:
*Zip/Postal Code:
*City:
*Country:
*E-mail:
CONTRIBUTION
*I wish to present a talk
20 minutes
40 minutes
Tentative Title:
I don't wish to present a talk
ACCOMMODATION
(provided by the organizers)
single
double
triple room in "Dworek"
student dormitory
Date of arrival:
Date of departure:
ADDITIONAL INFORMATION
(accompaning person, comments, suggestions etc.)
Copyright © 2007 Wojciech M³ocek