R E G I S T R A T I O N   F O R M


Surname :.....................................................................

Name :....................................................................

Institution:.............................................................

Address:.............................................................

e-mail:

fax: 

I wish to attend the conference and present an:

 Oral   Contribution ..(Y/N).. 
 Poster Contribution ..(Y/N)..
 
Title:.............................................................

Author(s):.........................................................

Affiliations:......................................................

Abstract:



The Hotel in which you wish us to arrange your accommodation in Puebla :
		       1. Hotel Camino Real      ( )
                       2. Hotel Posada San Pedro ( )
                       3. Hotel Royalty          ( )
                       4. None                   ( )

    Type of Room : Single ( )      Double ( )	 
		   Jr Suite [for those at Royalty] ( )

    Number of people accompanying you:

    If you would like to share a double room with another conference 
participant, please provide his/her name :

  Date of Arrival :

  Date of Departure :


  In order to help us give you a better service, we will appreciate you reply 
the following questions too:

  Are you a student? [YES/NO]

  Are you male or female? [M/F]

  Are you a smoker? [YES/NO]

  Are you a vegetarian? [YES/NO]

  Will you need some kind of child-care facilities? [YES/NO]

  Are you likely to attend the reception on Sunday evening?  [YES/NO]

  If you have any special needs please explain it below: 



 ------------- Send this form to: cosmo99@inaoep.mx ---------------