REGISTRATION AND ACCOMMODATION FORM

School on Singularities in Algebraic Geometry & String Theory

Centro Interdisciplinar da Universidade de Lisboa,
Lisbon, July 8-17, 1999
IF YOU WISH TO PARTICIPATE PLEASE FILL IN AND RETURN THE FORM BELOW NOT LATER THAN APRIL 30th, 1999.
IMPORTANT NOTE: if you have problems in submiting this form please fill in and send by email the form avalable as text file.

NAME:

AFFILIATION:

ADDRESS FOR CORRESPONDENCE:

E-mail ADDRESS:

PHONE:

FAX:

IF YOU ARE A GRADUATE STUDENT OR RECENT PHD PLEASE INDICATE YOUR MAIN RESEARCH INTERESTS AND THE NAME OF SOMEONE WILLING TO SEND (IF NEEDED) A RECOMMENDATION LETTER ON YOUR BEHALF:

PLEASE INDICATE THE DAYS FOR WHICH YOU NEED HOTEL RESERVATION:
ARRIVAL DATE:
DEPARTURE DATE:

ACCOMPANYING PERSON(S):

TYPE OF ACCOMODATION
(SINGLE, DOUBLE, SHARED DOUBLE):

IF YOU REQUIRE FULL OR PARTIAL FINANCIAL SUPPORT IN ORDER TO ATTEND, PLEASE EXPLAIN YOUR SITUATION: