REGISTRATION FORM

Name & Surname:

Affiliation:

Address:

Phone:

Fax:

E-mail:

Contribution:

Oral communication

Poster

Title:

Abstract:

Arrival/departure (mark from-to):
 

June 4

June 5

June 6

June 7

June 8

June 9

June 10

Hotel (approximate prices, single room per night):
 

University guest-room ($15.00)

Pod Roza ($40.00)

Helios ($75.00)

I am coming alone

with an accompanying person.

Special requests:

Conference fee:

$120.00	Accompanying person $60.00
I will pay later
Bank transfer to the account of   Nicholas Copernicus University   at   BIG Bank Gdanski S.A., II O/Torun Sz. Chelminska 17, 87-100 Torun, Poland Acct #: 11602068-67054001 "XXXIII SMP" (swift code: BIGBPLPW)

Click here to    this form.

Click here to    your participation form.

Back to the  XXXIII SMP  page...