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Workshop

"Special Geometries in Mathematical Physics"
 



   Registration




FORM FOR PRE-REGISTRATION

Surname: 

First Name:  

Female

Title: 

Affiliation:  

Address:  



Phone:    

Fax:       

e-mail:  

Do you propose to give a talk (please note that it might be impossible to
arrange a slot for everyone to avoid a tight schedule)? If YES, please send us
the title and a short abstract.




In case of a final registration:
Accompanying person(s):

Date of arrival:  

Date of departure: 

Letter of invitation: 

Letter of invitation for visa:  

Number of nights:

Special requests (e.g. vegetarian etc): 

Date:  

Signature (in case of fax or air mail registration):





Heike Pahlisch / 05.01.2006