FUSION03: Registration Form

Registration and Hotel Reservation Form

All the participants should submit this form. The deadline is September 20, 2003.

The fields with "*" are required to be filled.

Family Name *

Given (and Middle) Name *

Male Female
Title (Prof. / Dr. / ...)
Nationality
E-mail *
E-mail (once more) * Type E-mail address again for confirmation.
Institution
Mailing Address *
Phone *
Fax
I have submitted or will submit a contribution paper. *
Yes No
Number of accompanying persons *

Name of accompanying person(s)
Dietary requirement
Please let us know if you have a special requirement on the meals (e.g. vegetarian).
Arrival
Please let us know your approximate arrival time if possible, for the preparation of reception.
I will arrive at the hotel.
I ask the arrangement of accommodation. *
No
If you need the arramgement by the coference, get contact with the secretariat before submitting this form.
Check-in date (Reception is planned in the evening on Nov. 11.)
Check-out date (Conference will end at 12:30 on Nov. 15.)
Room type
In case of double or multiple use of a room, please specify possible roommate(s).
I will share a room with

When you press the "Submit" button below, this form will be sent to the FUSION03 secretariat. An acknowledgement will be sent to your e-mail address.

If you have already sent this registration form, resubmission will be ignored. If you need to change your former submission, please contact the FUSION03 secretariat.

FUSION03: From a Tunneling Nuclear Microscope to Nuclear Processes in Matter

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Registration and Hotel Reservation Form