Registration Form

Please complete and submit the application form below before April 15th, 2010.
The entries marked with an asterisk (*) are optional.
Deadline: next 15th April 2011.

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

City

Postal code Country

E-mail Homepage(*)

Phone number(*) Fax number(*)

Will participate in banquet

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):