Registration Form

 I intend to take part at the Eighth Biennial IQSA Meeting
 QUANTUM STRUCTURES'06, Malta,  July 9--14, 2006, Malta.

Surname:
Name:
Accompanying person(s)
(name(s)):
Institution:
Mailing Address:
Zip Code:
City:
Country:

E-mail:                            Phone: Fax:
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I would like to give a general (40 min) talk     Yes     No
I would like to give a (20 min) talk             Yes     No
I wish to present a poster                       Yes     No

(Tentative) title of your presentation:

I wish to organize a workshop                    Yes     No
If yes,
subject of the workshop

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I apply for the reduced price                    Yes     No
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