and Unification of Fundamental Interactions DESY, Hamburg, Germany
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Registration Form |
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Please register using the form below. The workshop fee will be 100 Euro, to be payed via bank transfer ahead of time, via credit card or in cash at the time of arrival. The registration will cover the welcome reception, the conference dinner, the excursion, and coffee during conference breaks.
Methods of payment:
Name | |
Firstname | |
Title | |
Home Institute (to appear on the badge) | |
Street | |
Zipcode | |
City | |
Country | |
Phone | |
Fax | |
Participation | from to |
Accompanied by (number of persons) | |
Vegetarian (yes/no) | |
Questions or Comments | |
Method of payment (Bank Transfer=BT / VISA Card=VC / EURO Card=EC) | |
Credit Card holder name | |
Credit Card number | |
Expiration date of Credit Card | |
Please the filled-in
reservation form,
or click here to all fields. You will get a confirmation on the screen and by e-mail. |
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If you want to send this registration form by fax, please use this template.
Send it to
Nora van Looveren
DESY Hamburg
Notkestraße 85
22607 Hamburg, Germany
FAX : +49 40 8998-4900
Last changes: 03/04/2001 by Marcus Hohlmann 09/02/2001 by Cristobal Padilla 22/02/2001 by Norbert Tesch 05/12/2001 by Ties Behnke |
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