Registration Form

Please complete all fields in the form below to register for the ECCL 2010 meeting in Sterdyn. Once your details have been received you will be added to the list of participants.

If you need to make any changes to the information you have previously sent simply fill out the form with your name and the fields which you need to add/alter.

Participant Details

Title:
Surname:
First name:
Gender:

Contact details

Department:
University/Institute:
Address:
City:
Postcode:
Country:
Telephone No.: (please include the international dialling code)
Email Address: (required field)

Accompanying person

Title:
Surname:
First name:

Speakers/Posters

I am a speaker at the meeting: No Yes

Title of talk:

 

I am submitting a poster(s) as the presenting author: No Yes

I will submit posters

Provisional Title(s):

 

Please see the abstracts page for details on how to submit abstracts for poster/talks

Travel

Would you like to take the shuttle bus from Warsaw to Sterdyn on Monday 23rd August: No Yes

Would you like to take the shuttle bus from Sterdyn to Warsaw on Friday 27th August: No Yes

Accommodation

Your accommodation at the Ossolinski Palace will be booked for you by the meeting secretary.

To book your accommodation and arrange the shuttle bus to/from the airport we require the following information:

Please indicate when you intend to arrive:

Day: Approximate time:
Is this your flight arrival time at Warsaw Airport?   No Yes

And the day you intend to leave:

Day: Approximate time:
Is this your flight departure time at Warsaw Airport?   No Yes

Please indicate if you require a single, double or twin room   

If you selected a double or twin room will you be sharing it with an accompanying person: No Yes

If not please give the name of the person with whom you will be sharing (if known).
If you have not given a name, but wish to share a room the organisers will assign a room-mate.

Any other comments:e.g. Vegetarian

Deadline for registration is: 10th June 2010

 

If you need to make any changes to the information you have previously sent simply fill out the form with your name and the fields which you need to add/alter.