XIV OPTIMA Meeting, Palermo 9-15 September 2013

PRELIMINARY REGISTRATION FORM
         After pressing submit this form will create an e-mail that will be sent by your mail-client.

I intend to participate in the XIV OPTIMA Meeting and wish to receive the Second Circular (due March 2013).

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*Name:
*Surname:
Institution:
Street:
*City:
Zip code:
Country:
Tel.:
Fax:
*Email:
I am:	Ordinary member Associate member Non member Student
I intend to participate with:	Poster presentation Oral presentation

Provisional title:

* Mandatory Fields

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If you have any question please feel free to ask by e-mail secr@optima-bot.org or by telephone:

Tel: (+39) 09123891209
Fax: (+39) 0916165997

TO BE RETURNED AS SOON AS POSSIBLE, PREFERABLY BEFORE 30 JANUARY 2013

 

Page editors. This page last updated 28 December 2012.