EPUNet Conference
SOEP 2004 and EPUNet 2004

Registration Form
 
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Please complete and submit this form online before 10 June
Or print and fax it to Kate Tucker on:
+44 (0) 1206 873151
Registration Form EPUNet 2004 Conference
Berlin, June 24th to 26th, 2004
Family Name
First Name
University/Company
Department
Address Line 1
Address Line 2
City
Country
Postcode
Phone
Email
   
I will participate in the conference on
please tick appropriate
Thursday Friday am
Friday pm Saturday
I will attend the reception on the evening of June 25th
Yes No
I would like to attend the MoMA tour
(€14 per person)
German English
Date Signature
   
  PLEASE NOTE: DEADLINE FOR REGISTRATION IS JUNE 10 th