Registration form Use one Registration form per person Use tab or mouse click to move in the form A. Registration




Дата канвертавання19.04.2016
Памер21.42 Kb.
5th International Symposium on Emys orbicularis
19–21 August 2015, Kiten - Bulgaria


Registration form



Use one Registration form per person


Use TAB or mouse click to move in the form


A.Registration




Surname

     

First name

     



Institution


     



Street


     



City


     

Postcode

     


Country


     


E-mail


     


Number of accompanying persons (non-participating in the scientific program)


     




Probable date of arrival

     

Probable date of departure

     


B.Accommodation and meal

This part of the Registration form is given for participants interested in use services of the Holiday House "Kiten" only.


 Yes, I plan to use offered possibility of accomodation in the Holiday House "Kiten"
Please fill a number of beds in (Holiday House "Kiten" has not single-bedded room).


Twin-bedded room

Triple-bedded room

Single person in twin-bedded room

     

     

     

 Yes, I plan to take meals (full-board) in the Holiday House "Kiten"



Number of days


     

Number of vegetarians

     



Notes (e.g. names


of roommates etc.)

     



C.Presentation

 Yes, I plan to perform oral presentation(s)



1. Title


     


Author(s)


     



2. Title


     


Author(s)


     


3. Title


     


Author(s)


     


 Yes, I plan to perform poster presentation(s)



1. Title


     


Author(s)


     



2. Title


     


Author(s)


     



3. Title


     


Author(s)


     




Notes (e.g. demand for special equipments etc.)


     


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