REGISTRATION FORM

First name: ……………………………………………………………………………………………….
Last name (surname): ………………………………………………………………………………..…..
Present position/title: ………………………………………………………………………………….…
Institution: …………………………………………………………………………………………….….
Mailing address: ……………………………………………………………….…………………………
City: ………………………………………………………………………………………………………
Zip/postal code: …………………………………………………………………………………………..
Country: …………………………………………………………………………………………………..
Fax/Phone: ……………………………………………………………………………………...………...
E-mail: ........................................................................................................................................................

Title of oral communication or poster: .......................................................................................................
Author(s): ...................................................................................................................................................

Mode of presentation:
				oral communication [   ]
				poster [   ]

My oral presentation requires:
► overhead projector [   ];
► slide projector [   ];
► video projector connected to a computer [   ]

Do you want to join the Sunday excursion?
YES [   ]
NO [   ]

Do you want to attend the banquet on Saturday evening?
YES [   ]
NO [   ]

Do you want to get a certificate of attendance upon check-in at registration desk?
						YES [   ]
						NO [   ]

Do you have special needs for food?
					Vegetarian [   ]
					Vegan [   ]

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Notes:

Please fill-in and type an ‘X’ within the square brackets to indicate your option or leave blank if not applicable. You may register without presenting a poster or oral communication.
Please return the completed form by and not later than the 1st of March, 2014!