Registrationform IPA Fall-days 1999

Name:
Badge name:
Affiliation:
Address:
Town:
Country:
Phone:
E-mail:
Date of arrival:
Date of departure:
Diet: Standard Vegetarian
Room: Single Share
(Ph.D. students are supposed to share a room)
IPA Participant:
Speaker
Ph.D. student
Speaker/Ph.D. student
IPA member
Associated Participant
Other
Other information: