REGISTRATION  CARD

 (Submit until January 31 th 2006)

 

VI-th International Conference  ION 2006

 Kazimierz Dolny, June 26-29, 2006

 

Surname:  

Name:       

Title (Prof., Dr., Mrs, Mr):  

Company/Institution:  

Street:        

Post code:  

City:     

Country:

E-mail: 

Phone: 

Fax:     

 

Form of presentation:

oral

poster

participation only

 

Accompanying person ?

No

Yes

 

Single or Double room ?

Single room

Double room

 

Student ?

No

Yes

 

Title of contributed paper:

Author(s):

Corresponding author: