COMBINATORICS  2006
June 25th-July 1st
REGISTRATION FORM

Please fill this form and send it by e-mail to
combinatorics2006@dma.unina.it
or fax to
+39 081 7662106
before March 31st 2006. Do not forget to indicate your e-mail address to receive our confirmation reply. 

PERSONAL INFORMATION

Title ____________        

Name________________________ Family name ___________________________

E-mail __________________________________

Phone __________________________ Fax _______________________________

Web Page ___________________________________________________________

AFFILIATION

Position ___________________________________

University or Institute ______________________________________

Department ________________________________

Postal code ___________    Street / P.O. Box ______________________________

City ________________________________

Country ____________________________

I plan to give a 15 minute talk. Title ___________________________________
      ____________________________________________________________________            

If so, I will send the latex file of my abstract by e-mail to  combinatorics2006@dma.unina.it  by  April 15th, 2006.

I do/I do not intend to submit a paper for the Proceedings

ACCOMPANYING  PERSONS

Number ____________________

1)  Name _______________________   Family name ________________________
     
     Address __________________________________________________________

2)  Name _______________________   Family name ________________________
     
     Address __________________________________________________________

3)  Name _______________________   Family name ________________________
     
     Address __________________________________________________________

TRAVEL AND ACCOMMODATION

I expect to arrive in Ischia on   _____________________________

I expect to leave Ischia on _________________________________

I sent by fax the reservation form to Hotel Continental Terme.

REGISTRATION FEE

(Your registration will be complete only after the payment of the registration fee.)

I have paid my registration fee of € ___________ on ___________________________.

SPECIAL REQUESTS

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