RENCONTRES DE MORIOND

QCD and High Energy Hadronic Interactions

REGISTRATION FORM

Mr or Mrs :
QCD session 18/25 March 06
Family name :

First name :

Date of birth (dd/mm/yyyy):

Nationality :

Professional status :

Is this your first attendance :
Yes No
Are you :

Fields of interest :

Collaboration :


Home institution address :
Name :

Street/PObox/etc :

City :

Postal code :

Country :

Phone :

Fax :

Email :


Institution mailing address (if different from institution address) :
Name :

Street/PObox/etc :

City :

Postal code :

Country :
Phone :

Fax :

E-mail :


Which institution should appear in all the conference documents ?

Will you be accompanied ?
by spouse/husband ?
yes no
Name and first name :
By your children ?
yes no
First name
First name
First name
birth date (dd/mm/yyyy)
birth date
birth date

If you wish to have a single room, please mention it (suppl. of 140 euros)
To share a room, please specify :
What will be your approximate time of arrival on Saturday March 18th ?
by ?

Will you use the conference bus :
on saturday, March 18th, from Geneva airport to La Thuile at 13h30 ?
n° of seats :
on saturday, March 25th, from La Thuile to Geneva airport at 12h30 ?
n° of seats :


Contact : conference secretary
Registration form 'pdf'