Preliminary registration form

Note: Please check the data before submitting. Should you wish to change the submitted data (for example when you decide to cancel your registration), please do not use this form but write to us. Once the form is posted, you will be associated a three-digit registration number, say "abc". Please use this number when making the payment of the conference fee (via a bank transfer) by filling "VS 5261abc" in the field "DETAILS OF PAYMENT". For example, if your registration number is 125, you should fill "VS 5261125" in the appropriate field. Your registration number is kept in the [preliminary list of participants].

Please use the TeX conventions when filling letters with accents.

Title :
Given Name(s) :
Surname :
Sex :
Accompanying person(s) :
Address :
Country :
Postcode :
E-mail :
Fax :
Phone :
Special wishes :
And now or .

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