Registration - EuroComb 2003

Prague, September 8 - 12

Mr.
Ms.
Given name:
Family name:
Address: Phone:
Fax:
E-mail:
Name and affiliation
for the name tag
(write accents in TeX):
Date of Arrival:          Date of Departure:
Accompanying person(s)*: No Yes      Number of accompanying persons:
Preferred accomodation: Campus dormitory Hotel Wienna none
Single Double     I wish to share room with:
Registration: Full Student     Additional banquet tickets:
Payment: Bank transfer Credit card
Specials (dietary
requirements, etc.):
*) Accompanying persons are not supposed to attend the scientific program.
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