IWEPNM 2010: Application for Participation

Kirchbergian

If you have participated at the IWEPNM 2009 or 2008 and your affiliation has not changed, please check the checkbox, enter your emailadress and press "Submit". An email with a registration link will be send to the given adress.

I participated at the IWEPNM
Email:

Personal information:

Title:(*)
First name:(*)(*)
Middle initials:
Family name:(*)(*)
Your gender?(*) Male Female
Are you under 36?
Are you a student?
Application for financial support?

Preferred category (please select two different categories):
1st choice category:(*)
2nd choice category:(*)
click for further information

Number of accompanying persons
(including children):(*)
(cat. A: 620 €, cat. B: 500 €, cat. C: 400 €)
Number of accompanying persons
between 2 and 6
under the age of 2
I am interested in childcare
If necessary please use the text box at the bottom of the page for additional information.

Affiliation:

University:(*)
Institute:
Street:(*)
ZIP Code or
Postal Code/Zone:(*)
City:(*)(*)
Country:(*)(*)
Email adress:(*)
Phone number:
FAX number:

Further remarks:

(*) required information
(*) will appear on your name tag

I agree that my name, my affiliation and my email address will be distributed to all other participants of the Winterschool.

Supporting companies: