WCM V1.8 © ERUDICIO SARL 2012 - 2017
       

Registration is closed or not open yet. Contact the LOC secretary, Dr Vincent BALTER, for any further information.

GEOMED13 - REGISTRATION FORM
 . All fields marked * required. Thank you.
 . If you are not sure of your current wishes or info, you may modify them later, after registration, until payment is done.
 . Please, add geomed13@erudicio.com to your contact book in order to receive GEOMED13's email automated notifications, and information about the conference (send by the LOC committee).
 
 Important notice: Full accommodation is included in double room for two people (select a roommate or fill in your accompanying person).
- choosing "no room" is useless
- If you wish, single room is available (double room for single use) for a 80 € TTC extra fee
 
Participant identity
Title*
Name*
Firstname*
E-mail*
You are*
 
Particulars
Complete Affiliation(s)
 (University, company, labs,UMR...)*
Affiliations' acronyms'
 (only acronyms. Will appear on your GEOMED13 badge.
 30 caracters max)
*
Email of administrative contact
 for payment and billing*
Address 1*
Address 2
City*
Zip code*
Country*
Retype your own E-mail*
Phone number*
 
Accommodation & attendance information
Date of arrival*
Date of departure*
please first select your arrival date above
Vegetarian*No|Yes
Room*No room|Single room|Double room
Anti spam protection (reCaptcha by Google)
Please, type the two displayed words in the form below in order to verify your real existence. Then click the "register" button to complete your registration to GEOMED13. Thanks !
Registration is closed.