SPIN-Praha-2006

LHC-Praha-2003

Symmetries and Spin

July 19 - 26, 2006

Prague, Czech Republic

REGISTRATION FORM

 Deadline:  July 10, 2006 

Please fill in this form to register to Spin-Praha-2006. We also accept e-mail with the same information, but electronic submission of this web form is strongly preferred.


Registration


Prof. Dr. Mr. Ms. or  Other:

Family name:

Name(s):

Institution (full name):

Home Institute address:

Phone (office):

FAX:

E-mail:

I am planing to give a talk:
Preliminary title:

Preliminary arrival date:


Preliminary departure date:


I am planing to reach Prague

by plane, flight N


by train, N


by car


Visa Information

If you need the visa for Czech Republic, please, specify



Date, month and year of birth:

Sex:

Citizenship:

Passport number:

Date, month and year of issue:

Date, month and year of expiration:

Place of applying for the visa:

(country and city in which the Czech Consulate is available)


Accompanying Person(s)

Name(s):

(children under 16, if any, name and year of birth)


Housing Reservation

accommodation and housing information


I would like to draw attention of the Local Organizing Committee to the following requirements and/or comments:

Comments:




Last modified: May 24, 2006 by Elena Kolganova