DIFFRACTION 2000 - Registration Form

 Deadline:  July 21, 2000 

 
Please fill this form to register to DIFFRACTION 2000. We will also accept e-mail with the same information, but electronic submission of this web form is strongly preferred.

Last Name: (required)
First Name: (required)
E-mail: (required)
Institution: (required)

Address (required):

Phone:
FAX:

I plan to give a talk  / to present a poster  :

Title
 

Abstract

I plan to reach Cetraro (required)
 by plane
 by train   (Italian Railways / Ferrovie dello Stato)
 by car

Date of arrival (mm/dd):       (required)     Time of arrival (hh:mm):      (required)

Date of departure (mm/dd): (required)     Time of departure (hh:mm): (required)

I plan to bring to the Workshop no.  companions

I would prefer an accommodation in
 Single room
 Double room
 3-4 bed residence

Having chosen double room / 3-4 bed residence, here is a list of my room mate(s):

We will do everything possible to accommodate you according to your choice. Should this not be possible, we would inform you in a short time.


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

I hereby authorize the Organizing Committee to process, make use of, and transmit further the personal information provided by me, in accordance with the forms and methods set down by
Italian law, and for the sole purpose of activities connected with the organization of the DIFFRACTION 2000 Workshop.


                                                               Signature  (required)

 

If your submission is successful, you should promptly receive an acknowledgment by e-mail.