Reionizing the Universe
Registration


After completing this form send it to the Organizing Committee by clicking on the "Register!" button at the bottom. Upon submission of this form, the webserver will notify you by means of a confirmation message. Later you will receive an acknowledgment of receipt by e-mail.

Surname:
Given name(s):
Name on badge: (if different from above)
Position:
Institute:
Inst. address:
Postcode: City:
Country:
Telephone:
Fax:
E-mail:
 Do you expect to give a presentation? .

 

The early registration fee is € 200.-- EUR. After April 15: € 250.-- EUR.
Payment for early registration should have been received by April 15 2005.
Transfer the appropriate Euro amount to Rabobank account:
3294.31.900 of the Kapteyn Institute, Landleven 12, 9747 AD Groningen
(IBAN: NL13RABO0329431900, BIC: RABONL2U).

Bank address:
     Rabobank
     Griffeweg 80
     9723DR Groningen
     The Netherlands

If you prefer to pay with a credit-card then please connect to the following secure web-site.
Please note that we can only accept Visa-card and Mastercard.