FIRST NAME:
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LAST NAME:
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SEX:
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AFFILIATION:
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POSTAL ADDRESS:
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COUNTRY:
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E-MAIL ADDRESS:
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PHONE NUMBER:
FAX NUMBER:
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| SPECIAL DIETARY REQUIREMENTS: |
Yes |
No |
| If Yes, please specify details: |
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| WANT TO GIVE A TALK: |
Yes |
No |
| Title: |
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Short abstract (150-400 words):
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| ACCOMMODATION (see description):
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| If yes:
Arrival day: August 2004
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Departure day: August 2004
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| Room type:
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If shared, preferred roommate:
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| REGISTRATION COST:
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330 EUR
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(includes course materials distributed during the school, revised lecture notes published by Springer
after the school, lunches, refreshments for coffee breaks and conference dinner)
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| EXTRA DINNER TICKETS (20 EUR each):
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| TOTAL COSTS PAYABLE (reg.cost + ext.dinner):
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EUR
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| METHOD OF PAYMENT: | BANK TRANSFER |
BANK TRANSFERS in EUR should be made to the following account:
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| Bank's name: | Union Bank of Estonia |
| Bank's address: | 2 Tornimäe st, 15010 Tallinn, Estonia |
| SWIFT: code | EEUH EE 2X |
| Beneficiary: | University of Tartu |
| Beneficiary's address: | Ülikooli 18, 51014, Tartu, Estonia |
| Beneficiary's account: | 10102000234007 |
| IBAN: | EE28 1010 1020 0023 4007 |
| Reference: | SMTAT-AFP04, <your name> |
It is VITAL to that you include the reference and make sure that you are paying both
the sender's and receiver's charges.
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| COMMENTS/ADDITIONAL INFORMATION:
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