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      REGISTRATION FORM (please, return before May 1, 2006)

   Last Name :
   First Name :
   Your name/affiliation on the badge:

   If you did not pre-register, than give -
      Affiliation :
      Address :

      Tel. :                  Fax :               E-mail :

   ( ) I plan to attend the Conference on E&LSNP
   ( ) I will not attend

   I propose to make a presentation at the Conference on E&LSNP
   entitled :


   ( ) I prefer to make oral presentation (about 15min + 5min discussion)
   ( ) I prefer to make poster presentation


   I need -
      an entry visa         :   ( ) Yes   ( ) No
      a hotel accommodation :   ( ) Yes   ( ) No
      a supporting grant    :   ( ) Yes   ( ) No

   Number of accompanying persons:

   ( ) I will transfer the registration fee to the given account
   ( ) I will pay the registration fee in cash on arrival

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