INFORMATION/REGISTRATION FORM

Hysteresis and Slow-Fast Systems (HSFS-2011)

December 12 - 14, 2011

First name: _________

Family name: ___________

University affiliation: ________________

Email address: ________________________

Arrival date:  December ____ (earliest possible December 11)
Departure date: December ___ (latest possible December 15)

Vegetarian food: Yes __ No ___

Estimated travel expenses: _____ EUR

Do you need a visa? Yes___ No__

Full name of accompanying person
(accommodation and travel 
expenses are not
covered by organizers): ____________________

Title of the talk: _________________________