Registration form

Name

Surname

Affiliation

E-mail

I will attend

19th and 20th only 19th only 20th

Are you interested in the social dinner on Monday 19th? Cost. approx. 35€

19th and 20th only 19th only 20th

Do you have any dietary restriction?

None Vegetarian Vegan Gluten-free Lactose-free

Are you interested in giving a talk?

Yes No

If so, write the title of the talk.

Note/Request

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