Registration Form

RAMIS 2005
Accommodation
Final Registration Form
Poznań-Będlewo, April 24-28, 2005
Accommodation in double and single rooms, check the appropriate dates:
Surname and first name…………………...…………………………………..……….…
Title (Prof., Dr., M.Sc.)…………….. Sex
M
F
E-mail……………………………..Phone/Fax…………………………………………..
Accompanying person……………………………………………………………………
I wish to present the following contribution:
Oral ;
40min. 30 min. ..............................(invited speakers)
15 min. (for PhD students and young Post-Doctoral scientists)
20min. .............................(other speakers)
poster
Title of oral presentation
……………………………………………………………………………………………
……………………………………………………………………………………………
Authors (speaker underlined)
……………………………………………………………………………………………
Registration fee
Accommodation included:
Participant:
250 EURO
PhD student or Post-Doctoral scientist:
150 EURO
Accompanying person:
170 EURO
Accommodation excluded:
Participant:
100 EURO
I send the registration fee by bank transfer through (please enclose the copy)
……………………………………………………………………………………………
...........................................................................………………….....…....................., to:
Name and address of your bank
date
Registration fee should be sent by bank transfer in EURO to:
Bank
Bank Zachodni WBK SA, Poznan (Poland)
Account Name
Institute of Molecular Physics – RAMIS2005
Account Number 2 O/Poznan No. 93 1090 1346 0000 0000 3423 4292
(Fill NIP of your institution on a bank transfer)
Polish participants should send the registration fee in ZŁOTY to:
Bank
Bank Zachodni WBK SA, Poznan (Poland)
Account Name
Institute of Molecular Physics – RAMIS2005
Account Number 2 O/Poznan No. 07 1090 1346 0000 0000 3402 4865
(Fill NIP of your institution on a bank transfer)
Late registration (after April 5, 2005) fee will be increased by 50 EURO.
24/25 April 25/26 April 26/27 April 27/28 April I wish share a room with: …………………………………………………….
Transport from Poznań to Będlewo: 24 April 2005
Conference Bus departures at 1500 and 1900 from Institute of Molecular Physics
Polish Academy of Sciences, Smoluchowskiego 17, Poznań.
Please make a reservation:
1500
1900
Please fill this form in capitals, check appropriate boxes and return together with
the copies of the bank transfers before 5 April 2005 and send Abstract to the
secretary of the RAMIS 2005 conference before 31 March 2005.