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Sources, Interaction with Matter, Detection and Analysis of Low Energy Electrons 2017 (SIMDALEE2017)

SIMDALEE2017 Registration Form

On-line Registration

  1. Fill in the following form.
  2. Check the contents and press <Submit> button.
  3. Confirmation page will be displayed and confirmation e-mail will be sent automatically to your mail address.
  4. If you do not receive the confirmation mail after several hours, please contact the organizers. Do not re-submit this form to prevent multiple registration.
  5. Cancellation or amendment of the registration is also accepted via e-mail to the organizers.
  6. To guarantee your participation, payment of the conference fee is due until May 15th, 2017 (refund upon cancellation will not be possible). Registration without receipt of payment at this date will be automatically cancelled.
     
    Instructions for paying the conference fee.

Caution

  • [*] marked items are required fields and should not be empty.
  • Please use Unicode (UTF-8) Character Encoding with your Browser. (Otherwise only 7-bit US-ASCII characters will be treated correctly.)

Conference participant [*]: Male   Female  
Title [*]:
Family name [*]:
Given name [*]:
Middle name:
E-mail [*]:
Affiliation [*]:
Postal mail address [*]:
Zip code & City [*]:
Country [*]:
Phone:
Fax:

Invoice address if different:
    Affiliation [*]:
    Postal mail address [*]:
    Zip code & City [*]:
    Country [*]:

Number of accompanying persons: (if more than one please send details per e-mail.)
    Accompanying person: Male   Female  
    Name of accompanying person:

Hotel [*]: none  
Flamingo Standard Single Use  
Flamingo Standard Double Use  
Flamingo De luxe Single Use  
Flamingo De luxe Double Use  
Mare Pineta Standard Single Use  
Mare Pineta Standard Double Use  

Arrival day (DD/MM/YYYY) [*]:
Departure day (DD/MM/YYYY) [*]:

Menu style : regular   vegetarian   vegan  

Title of contribution:
Prefered type of presentation: poster   oral  
(an abstract will be due until March 31st, 2017)


 

simdalee2017/registration_form-test.txt · Last modified: 2016-11-18 18:54 by Wilhelm Hofer