Registration Form

Please complete and submit the application form below before March 27th, 2010.
The entries marked with an asterisk (*) are optional.
There will be a fee to be paid upon arrival of :

- 50 Euros for those participants who wish to take the lunches during the 3 conference days
- 70 Euros for those participants who wish to take the lunches during the 3 conference days and also the conference dinner.
- 20 Euros for those who only wish the conference dinner

There is no fee for all the others.

Last name
First name
Affiliation (organization/Institution)
Adress:
Street

City

Postal code Country

E-mail Homepage(*)

Phone number(*) Fax number(*)

Will participate in banquet

Will take launches during the 3 conference days

Do you wish to give a short talk (30 minutes) about a case study (of your own experience)
related with Mathematics for Industry

IF YES, PLEASE SEND US THE TITLE and a SHORT ABSTRACT
(preferably with a list of references):