Registration Form ITC 2004
(to be sent to the Conference Coordinator before January 31, 2004)
Name:
First name:
  Mr     Mrs/Miss
Title: scientific worker Prof. Dr Ms/Eng Student
Institution :
Address:
Postcode: City:
Country: Phone:
Fax: E-mail:

I wish to present a paper: yes     no

preferred style of presentation: oral     poster

Title of the paper:

Author(s) of the paper:

I am interested in exhibition facilities: yes     no