Moss 2005

Registration Form for Delegates

Family Name:
Given Name : Title:

Preferred names for badge:

Affiliation:

Country:

Email:

Telephone:

Do you wish to give a talk?* YES NO

Do you wish to present a poster?* YES NO

Special food (vegetarian/vegan/other (please give details)

Dinner choice Sunday:

salmon
chicken
goulash

Excursion Tuesday? YES NO

Payment (220 Euro for conference plus 52 Euro for the optional excursion) should be made by credit card. Please make sure and print the credit card payment form and submit it by fax to the number located on the form. The form can be downloaded anytime from the main webpage.
If payment by credit card present difficulties, please contact David Cove d.j.cove@leeds.ac.uk.

*The length of talks will be decided after I establish how many people wish to give talks. Talks will probably be between 15 and 30 minutes. Abstracts for talks must be mailed to d.j.cove@leeds.ac.uk, no later then April 14^th, 2004. See the Moss 2005 website abstract submission (downloadable word file) for more details.