November 2011 registration

PERSONAL INFORMATION

Mandatory information

Name *
Surname *
Degree *
E-mail *
Name of workplace or school *
Adress of workplace or school :
Street *
Street number *
City *
Post Code *
Country *

Nonmandatory information

First 200 registered participants can order the lunch
Yes, I order Thursday lunch
Yes, I order Friday lunch
Social Evening
Important notes (e.g. vegetarian, gluten-free food, ...)
Your mobile phone