REGISTRATION FORM TO THE JOINT MEETING HEIDELBERG-LIEGE-PARIS-WROCLAW (HLPW2008)
			 SPA, March 6-8, 2008


First Name:...

Last Name:...

E-Mail:...

Institution/Affiliation:...

Address:...

Zip Code:... 

City:... 

Country:...

Phone:...

Fax:...

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Day and Time of Arrival and Departure:
Arrival:...     
Departure:...

Means of transportation:...

Accompanied (double room or triple with children): Yes/No 

Vegetarian: Yes/No 

If yes, do you eat Fish ? Yes/No 

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Would you like to give a talk ? Yes/No 

If yes, a tentative title: ...