Registration Form




DO NOT TRY TO SEND THE FORM FROM THIS SITE.  Please copy and  MAIL / FAX / E-MAIL  to:

Sylvia Schur (Secretary), Department of Mathematics, Technion, 32000 Haifa, Israel
Fax: 972 4 829 3388  cms@math.technion.ac.il



 

Last Name:                                                 First Name:                               


Mailing Address:


Phone #:                                                             Fax #:


Email:  


Arrival Date:                                                    Departure Date:


# of accompanying  persons:




Hotel Accommodation

Single room

Room for two                                     Shared with

From:                             To:                                Number of nights:


I am interested in participating in the workshop banquet (to be held on Sunday, 15/6/03)   
           
Number of persons:


I am interested in participating in the workshop excursion (to be held on Saturday, 14/6/03)
 
Number of persons:




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