PLANCK 02
Fifth European Meeting "From the Planck Scale to Electroweak Scale"
SUPERSYMMETRY AND BRANE WORLDS
Kazimierz, May 25 - 29, 2002

REGISTRATION and ACCOMMODATION FORM


 
FAMILY NAME:
First name:
Institution:
Street:
Postal Code:
Town:
Country:
Phone:  
Fax:  
E-mail:  
Title of a talk:
Names of accompanying persons:
Rooms have been reserved in Dom Architekta and nearby hotels in Kazimierz.
Conference fee: 50 US$.
Full board and accommodation in Kazimierz (per person): single room - 400 US$, double room - 275 US$.
I would like to stay in:
  Single room Double room  
In case of a double room please give name of the preferred room-mate:  
 
 

The data below can be sent later:

ARRIVAL date, time, flight no.:
DEPARTURE date, time, flight no.:
Additional reservations in the hotel HERA in Warsaw (40 US$/day/person):
  23.05/24.05 24.05/25.05  
  29.05/30.05 30.05/31.05  
Other information and remarks: