IWCIA 2014

Registration

First name:
Middle name:
Surname(s):
Gender: Male Female
Vegetarian: No Yes
 
Current position:
Institution:
Department:
Address:
Postal code:
City:
Country:
E-mail*:
Be careful when typing the e-mail address because it will be used to send you a confirmation of your registration.
Number of accompanying persons: 
Accommodation required* Yes No
(if more than one room is required, contact organizers)
Type of room:  Single room Double room
To share a room with IWCIA participant:  Yes No
Arrival date*: May 2014
Departure date*: May 2014
Interest in the trip to Prague:  Yes No
Paper number (if any): 
Talk title (mandatory for authors of accepted papers):
 
Abstract (unless a paper has been submitted):
 
Coauthors:
 
Security question*: 9 + 2 = 
(*) required fields