Registration Form

 

General Information

Family Name: First Name:
Institute: Country:
Email: Phone:

Will you have lunch at the workshop ?     Yes     No
If yes, please indicate the number of meals/tickets required (including yourself and accompanying persons)    


Social Program

Will you attend the Workshop Dinner ?     Yes     No

Please, indicate the number of accompanying persons that will attend the social events

Welcome Cocktail: Visit to Valencia: Workshop Dinner:

Information about Social Events


Total fee for early registration (€)    


Accomodation

Arrival Date: Departure Date: Month:    November
Hotels: room

Information about Hotels


Payment (both ways either credit card or bank transfer are possible)

Please indicate the credit card type or "bank transfer":
If credit card, give number:
and expiration date:

To confirm your reservations please fill this form and fax it to +34 96 310 6787 (Tot Nou)
In case of bank transfer don't forget to put your name to identify the payment


Other comments & request for grants

Please add here the following information:
- request for a student grant if wanted together with some short report supporting your application (motivation, present activities, etc..),
- the name of your accompanying persons,
- any other information that does not fit anywhere else in this form.


 

 

List of people registered

Follow and Check your request at this page


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