Registration
 

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REGISTRATION FORM

 

*Family Name

*First Name
   

*Position

 Senior Scientist PhD Student Other
       

*Institution

*Department

*Address

*Postal Code
*City
*Country
*Phone

Fax

*E-mail

 ( Valid Email Required )

*Accompanying person

  
 
 

1 - I intend to submit a paper as:

 A) POSTER, with the following provisional title:

 

B) ORAL PRESENTATION (15 minutes) with the following provisional title:

   

2 - I would like to publish my contribution in an IOBC Bulletin:

Yes No

   

3 - I am covered by an IOBC/WRPS membership:

Yes No

   

If yes:

Individual Yes No

 

Supporting (Please state the name of the institution):

Institutional (Please state the name of the institution):

   

 

* Mandatory Fields

 
 

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