ICPS2000, Zadar, Croatia Registration form

Fill in and send this form to register for 
XV International Conference for Physics Students 
Zadar 4th - 11th August 2000.

Prefered method of registration is via online form at
http://icps2000.inet.hr/registration.html

You should fill in all the fields marked by asterisk (*).
You should write only in the space between brackets ([]).
You should use only ASCII characters. 
Please do not delete any part of this form.

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Personal Information -----------------------------

Last name *			[]
First name(s) *			[]
E-mail address *		[]
Mailing address *		[]
Country*			[]
Phone number			[]
Fax number			[]

Sex* (M/F)			[]
Date of Birth
(DD.MM.YYYY)*			[]
Passport number*		[]

University/institution*		[]
Department			[]

My annual IAPS membership
fee is paid by*
(number) 			[]
1 My National/Local Committee 
2 I am an Individual Member


Accommodation in Zadar ---------------------------

Choose one
(most should choose 1)*		[]
1 I apply for the accommodation and meals during the 
  conference
2 I don't need the accommodation or meals during the 
  conference 
  (participation fee will reduced to 60 euros) 


Participation at ICPS2000 ------------------------

Field of interest
(in physics)			[]

At ICPS2000 I will have:
a lecture titled:		[]
a poster titled:		[]

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Submitting 

Send the filled form by

e.mail to : icps2000@hfd.hr 
 (subject : Registration form)

snail mail to : 
 ICPS 2000 - Registration
 Hrvatsko fizikalno društvo 
     - studentska sekcija
 Bijenicka c. 32
 HR - 10000 Zagreb
 Croatia

Please note that in addition to filling in the form
you will have to pay the conference fee of 120 euros.

For details consult our web page 
http://icps2000.inet.hr/
http://www.hfd.hr/icps2000/