P R E L I M I N A R Y   R E G I S T R A T I O N   F O R M

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This is an individual registration form. For group participation
please send a copy of this registration form for each participant.

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The following part is designed to help us to make up the list of participants (please use block capitals, except e-mail address):
Name of the participant
Surname (Family name):
Other name:
Age:
School (place of work):
Full address

Line 1:
Line 2:

Tel (with country code number):
Facsimile:
E-mail:
The following informations will help us to make up the programme, please circle or fill in carefully: What branches of Mathematics are you interested in? Do you wish to give a talk, to present a computer program or a poster ? Yes No Please give the title and details (for poster presentations number of pages and their dimension as well): Line 1: Line 2: Line 3: