NPAE-2006: Registration form

REGISTRATION FORM You are about to enter and submit registration data. On filling in all fields of this form, press Submit button to send information to Organizing Committee of NPAE-2006. If something goes wrong, please, complete registration form in Acrobat or MS Word format (can be found in Documents section) and send to us by email, fax or regular mail.
Salutation:
First Name:
Middle Name:
Last Name:
Title/Position:
Institution/Organization:
Mailing Address: (street)
City:
Postal Code:
Country:
Phone:
Fax:
Email:	- required field
Date of arrival:	(DD.MM.YYYY)
Date of departure:
I have already submitted an abstract of my talk/poster Yes No
Title of your talk/poster:
Accomodation:	Insitute of the Post-diploma education
	Hotel "Mir"
	Another hotel (specify below)
	I need no hotel reservation Here you can specify all details regarding the hotel reservation!
Number of accompanying persons:
Accompanying persons:
Comments:	Place your requests here!
I understand that conference fee can be paid by cash only on arrival to Kyiv (during the registration) Hereby I indicate my wish to participate in the NPAE-2006 conference to be held in Kyiv, May 29 - June 03, 2006.
Date: