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REGISTRATION FORM

 

XXXVIIIth RENCONTRES DE MORIOND

ELECTROWEAK INTERACTIONS AND UNIFIED THEORIES

http://moriond.in2p3.fr/EW

Les Arcs, Savoie, France         

March 15-22 2003

 

Important remark: Talk requests should NOT be made through this administrative form, but sent by email to the program committee, as described in section III.3 of the bulletin (see Contribution Form).

 

PLEASE INDICATE CLEARLY YOUR NAME, FIRST NAME AND COMPLETE ADDRESS OF YOUR INSTITUTION ON THIS FORM

Mr    Ms      Name   .......................  First Name   ........

Date of birth   ......................Professionnal status ........

Experimentalist         Theorist      

Collaboration .....................................................

Field of interest...................................................................

HOME INSTITUTION ADDRESS  (1) .....................................

...................................................................

...................................................................

Phone :  ..............................................

Fax :  ................................................

E-mail : ..............................................

INSTITUTION MAILING ADDRESS (2)....................................

...................................................................

...................................................................

Phone :  ..............................................

Fax :    ..............................................

E-mail : ..............................................

Which institution should appear on all the

conference documents ? 1    or   2

HOME ADDRESS :     ................................................

...................................................................

...................................................................

Phone :  ..............................................

Fax :  ................................................

Will you be accompanied  : 

By your spouse   :  Name & First Name ..............................

By your children :  First Name  .................... Age ...........

       First Name  .................... Age ...........

       First Name  .................... Age ...........

If you wish to have a single room, please mention it

(suppl. of 161 Euros)            Yes          No                   

If you wish to share a double room, please specify :   

Smoker         Non-smoker         

What will be the approximate time of your arrival on

Saturday March, 15th : by train ....... by car  ......  by plane  ......

Will you use the conference bus : 

On Sat. March 15th from Geneva to Les Arcs at 12 h 30 :

No       Yes        Nthumber of seats  ......

On Sat. March 15th from Geneva to Les Arcs at 13 h 30 :

No       Yes        Number of seats  ......

On Sat. March 22nd from Les Arcs to Geneva at 12 h 00 :

No       Yes        Number of seats  ......

Date  :  ............................

 

Please return this registration form as soon as possible to :

Claude Barthelemy

Rencontres de Moriond

LPT - Batiment 210

Universite Paris-Sud

91405 Orsay Cedex

FRANCE

Phone : 33 (0)1 69 15 82 16

Fax : 33 (0)1 69 15 82 87

E-mail : mailto:moriond@th.u-psud.fr

 

DEADLINE FOR REGISTRATION : DECEMBER 30TH, 2002

NO HOTEL RESERVATION WILL BE MADE WITHOUT THIS REGISTRATION FORM