Workshop2012:registrationform

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Registration form

If you have already send this form, please do not send it again!

In order to amend you application or with other queries please email gsaw2012@gmail.com


Contact details

Title (Mr/Mrs/Dr/Prof):

Name:

Affiliation:

Work address:

Telephone:

Email:


Please give a short description of your current research and research interests, as well as a description of how you will contribute to and benefit from the workshop (<400 words)



My contribution to the Workshop:

Title:

Brief abstract:


Social Dinner

We plan to have a workshop's dinner on Thursday 6th in the Osteria la Matta

I would like to participate in the dinner:


Other

Special dietary requirements (e.g. vegetarian, vegan):

Disabled access:


Funding

Should you request any funding support, please email us directly with a justification and an estimate of the travel and accommodation costs. The support is available primarily for students and postdocs.



Now, make sure everything you entered is ok. If form is processed successfully you will receive a confirmation email.



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