Final on-line registration form Personal data: Name: Surname: Female Male Title*: Institution*: Address*: City*: Postcode*: Country*: Phone*: Fax*: E-mail*: Arrival: Arrival date (dd/mm): I plan to come by air train other Departure date (dd/mm): I plan to leave by air train other Conference fees: Participant professional 500 PLN student 300 PLN Accompanying person(s) number of accompanying persons: 0 1 2 3 4 5 fee: (250 PLN each) PLN I am intending to present: 0 1 2 3 poster(s) 0 1 2 3 oral presentation(s) Preliminary title of presentation: if you wish to present more than one, please write below all titles and note poster/oral presentation after each title I am interested in panel discussion on the following topic: *Provide this information if changed or not given in previous registration TO SUBMIT FORM YOUR WWW BROWSER HAS TO BE ABLE TO USE MAILTO: COMMAND. You are NOT registered until you will get our confirmation, it may take few days.

Last modification 3.08.2000

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