Registration Form

Please fill out all fields with *, and click "View" when you are finished

* Family Name:
* First Name:
Affiliation 
* Institution:
* Street address:
* City:
* Country:
* Zip/Postal Code:
* Email address:
Mailing address
(if different from the above):
I wish to present a talk: Yes:No:Maybe:
Proposed contribution title:
If you propose to present a talk, please submit an abstract before June 10 as an attachment to an e-mail to Borsuk_conference@impan.gov.pl. Please follow the form of the sample file.
I need an invitation letter: Yes:No:
Additional information
* Sex: Female:Male:
Vegetarian: Yes:No:
Smoker: Yes:No:
Requests and questions:
Accommodation
* Date of arrival:
* Date of departure:
Accompanying person(s):

Before submitting, please ensure that you have completed all fields marked with *