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YES CONGRESS 2009 - REGISTRATION FORM FOR CONGRESS PARTICIPATION
Personal Data
Surname: Mr. / Mrs. ………………………………………………………..........................................
First name: …………………………… Title/Professional position: ……………………Age: ………….
Company/Institution: ……………………………………………………
Address: ………………………………………………………………..
Postal code: ………………….. City: ……………………………………….
Country: ……………………….
Telephone: ………………………… Mobil: …………………………
E-mail: …..……………………………
I intend to:
(Choose all that apply)
____ Register for the Congress ____ Regular Participant ___ Student Participant
____ Give an Oral Presentation
____ I have already submitted an abstract
____ Present a Poster
____ I have already submitted an abstract
____ Present my work at a Roundtable
____ I have already submitted an abstract
____I plan to submit an abstract
____I plan to submit an abstract
____I plan to submit an abstract
____ Register for a Field Trip
PLEASE NOTE! REGISTRATION IS ONLY VALID WHEN ALL CONGRESS FEES AND FIELD TRIP
FEES HAVE BEEN PAID.
Date: ……………………………….
Signature: ………………………………………………………….
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