The Third Quantum Geometry and Quantum Gravity School, February 28 - March 12, 2011, Zakopane, Poland

 
 

 The Registration Form

All the information given in the Registration Form (excluding e-mail address) can be modified after login, until the registration deadline (31.01.2011).

Information matched by * is necessary

 1. Personal Data

*Title: 

*Family Name: 

*First Names: 

*Nationality: 

*Sex: 


 2. Proffesional Data

*Affiliation:  

*Address: (office)  

*Postcode/Zip code:  

*Town: 

*Country:

Your last publication on Quantum Gravity (if any):


 3. Contact

*E-mail: (note that this e-mail address will be used as an authorisation login name for further access to your registration data)

*Password: (for further access to your registration data)

*Retype your password:

Telephone: (To be used in case of emergency contact with you. Please include the country code).


 4. Arrival information

*Arrival date:      *Departure date:
(Please note that the first day and the last day of conference are March, 1 and March, 13, respectively.)

*Do you want us to make a reservation for you at the conference hotel?


You can give us any addditional information about Your arrival (aspecialy if you have chosen "other"), preferred room mate etc. in the textbox below. Please note that if you let us know your arrival and deprature time it will make possible for us to coordinate/organise transport from and to the airport.:







registration admin: Jacek Puchta