Pre-Registration

Organized by Institute of Physics, University of Bialystok

Navigation toolbar

You can fill in the form below to pre-register for the school. Fields labelled blue are mandatory and you cannot leave them blank. Other fields are optional.
If you have any questions, please e-mail us at school@alpha.uwb.edu.pl

Personal information

Mr Ms

First name:

Family name:

Title: Prof. Dr. PhD student Undergraduate

Institution:

Address:

City/code:

Country:
(Choose your country from list or type its name in the textfield)

E-mail address:

Telephone:

Fax:

I will be accompanied by...

First name:

Family name:

Poster session

I intend to present a poster
Tentative title:

Arrival and departure

Arrival date: Approx. time: Place:

Departure date:

Please type any comments or additional information here:

To submit your data, click here:

To clear this form, click here:

Web artwork:
Maciej Pietka