First and Last name:

VAT number/NIF:
(for receipt of fee payment)

Institutional affiliation:

Address:

Postal Code:

City:

Country:

Telephone Number:

Fax Number:

E-mail:

Title of your abstract

Workshop Paper presentationNone

Seminar fee:

¤50 (PhD students) ¤100 (ESREA Members) ¤150 (Non-ESREA members)

Payment is to be made at the desk of the seminar in Braga on June 14th 2007.
Please bring cash in Euros.

Do you have special needs? No Yes

Do you have food preferences? No Yes

Do you wish to join the Seminar Dinner? Yes No

The Seminar Dinner is estimated to cost up to 35 euros, it is not included in seminar fee.