BULGARIAN ACADEMY OF SCIENCES

COST Chemistry EUROPEAN COMMISSION

UNIVERSITY OF SOFIA

If you are interested in attending the Workshop then please return the form below by e-mail to quantum@rl.ac.uk or reply by telefax to Dr Yavor Delchev or by regular mail at the address below :

 Dr Yavor DELCHEV
 Institute of Nuclear Research and Nuclear Energy
 72 Tzarigradsko Chaussee
 1784 SOFIA, Bulgaria
 (Fax: ++ 359 2 975 3619)
 

Application form

 Full Name:     _______________________________________
 Sex:      M / F
 Country:        _______________________________________
 Research field: ___________________________________________

 Affiliation:   ______________________________________________
 Address:     ______________________________________________
                   ______________________________________________
                   ______________________________________________
                   ______________________________________________

 Telephone:   _______________________________________
 Telefax:        _______________________________________
 E-mail:         _______________________________________
 

 As numbers will be strictly limited, an early response is desirable. Please indicate your accommodation requirements (they will be fulfilled on the basis of earlier response)

 I would prefer / require a single room:       Yes / No
 I would prefer / require a shared room:       Yes / No
 (Please indicate who you would like to share with, if appropriate)
 I shall be accompanied:                                  Yes / No

 Indicate if you wish to extend your stay in Sofia before or after the Workshop, with the exact dates of arrival and departure:
 

 Please indicate any special dietary requirements:
 

 PLEASE REMEMBER TO IDENTIFY YOUR MONEY TRANSFER THROUGH YOUR BANK WITH YOUR NAME AND, WHEN APPROPRIATE, LET US KNOW ABOUT THE MODE AND DATE OF THE TRANSFER.
 

 If you would like to make a presentation at the Workshop then please complete the following:

 I would like to give a talk entitled

 __________________________________________________________________________

 __________________________________________________________________________

 in the session on (give initials)   ________

 Author(s) (please underline the speaker)

 __________________________________________________________________________

 I would like to give a poster entitled

 __________________________________________________________________________

 __________________________________________________________________________

 Author(s)

 __________________________________________________________________________
 

 The format for abstracts of the talks and posters can be found by clicking on the linkword abstract.