Registration form

Title Mr. Ms. Dr. Prof.

Name

Surname

Email

Date of birth

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Affiliation

Address

Module --------- Single crystal diffraction Powder diffraction

Status at ECS3 --------- young academic senior academic non-academic lecturer accompanying person organizer

Abstract

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Hotel category 3*** 4****

Room choice shared double room double room single use

I would like to share the room with

Date of arrival

September October

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2016

Date of departure

September October

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2016

Full board

Lunch box

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