Registration & Housing Form -- Paris 2011

Please use this form to register for the 11th Workshop on Non-Parturbative QCD (IAP/Paris 2011) and to receive further conference mailings. While we will also accept email with the same information, electronic submission of this web form is strongly preferred. In any case, only those returning a registration form will be sent further conference information.

* If you would like to present a talk, please communicate with the Chair of the relevant Session and submit a title and abstract to the Chair with a copy to Ms. Rotondo.
* Please see our website for information about accommodations and for all Registration information.

Registration & Housing:

Registration Fee: US$ 325.00 (if paid before 15 May 11) or € 275.00 ((if paid after 15 May 11)).

Number of accompanying persons:

Additional Cost: US$ 85.00 (€ 65.00) per each additional guest (banquet).

Methods of payment: cash, traveler's checks, or personal checks drawn on a French or U.S. bank; credit cards cannot be accomodated. Checks drawn on a U.S. bank should be made out to 'QCD21'; those drawn on a French bank should be made out to Chung-I Tan. All payments should be mailed, or given to Ms. Mary Ann Rotondo, Conference Coordinator, Physics Department, Brown University, Box 1843, Providence, Rhode Island 02912 USA.

Personal Information:

First (given) Name : Last (family) Name:

Institutional Affiliation:

Address:

Email Address :
Phone Number:
FAX Number:

Arrival Date (YYYY-MM-DD):
Departure Date (YYYY-MM-DD):


Remarks?

Send Registration :

The Reset button will clean your entries above. Click 'Preview' to confirm your choices. Push 'Submit' to send your registration directly. It is best for you to Preview your choices before you submit them: Click Submit only after reviewing your registration information: First you click 'Preview', then you click 'Submit'.

Inquiries:

Ms. Mary Ann Rotondo

Phone: (401) 863-1473
FAX: (401) 863-3697