BIT Circus 2012 - Registration Form
Last name
First and middle name
University
Department
Postal address
Zip code and city
Country
E-mail address
URL address
Phone number
Fax number
Arrival/Departure
Arrival date (day/month)
. Arrival time
Departure date (day/month)
. Departure time
I will participate in the Conference dinner on Thursday evening
Yes
No
Number of accompanying persons at the Conference dinner on Thursday evening
I will participate in the lunch
on Thursday:
Yes
No
on Friday:
Yes
No
Giving a talk?
Yes
No
Title of talk
Abstract
Ready to submit?
Yes