Registration Form

 
    Personal data
Family Name Title(s)
First Name    
 
Institute  
Street and No.
City ZIP
 
Country
 
E-mail Phone
 
    Conference contribution
Form of contribution:             Oral             Poster             None
Please complete: a title of contribution, authors, key words (3-5), annotation (max. 100 words).
 
    Accomodation requests
    The conference fee covers only the accomodation in 07.06.2012.
    In addition to that, I ask for the accomodation in the hotel Beltine also in:
 
06.06.2012                     Single room
08.06.2012                     Double room shared with
 
    Notes, remarks
 
    For the easier identification of your payment, the system will generate unique digits that will be assigned to you.
    Please use them at the payment as Details of payment.