Application form for QSCP VIII

First (given) name:
Last name (surname):
Title (Mr, Ms, Dr, Prof, etc.):    Sex:
E-mail address:
Complete mailing address:

Phone number:
Fax number:

Please indicate your level of interest in the Workshop
I will probably attend the Workshop
I will possibly attend the Workshop
I will not attend the Workshop but would appreciate receiving further details by e-mail
N.B.: The names of those respondants indicating their PROBABLE attendance at the Workshop will be listed as expected participants in the second announcement. The second announcement will be issued by e-mail to all respondants in April 2003. No further announcement will be made before this time.

Suggestions and comments:

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