LTC 2019 Registration Form

1. Personal data

1.1 First Name *

1.2 Surname *

1.3 Affiliation *

1.4 Mailing Address (postal) *

1.5 E-mail *

1.6 Telephone *

1.8 Participant category *

Non-student participant (payment before May 6 - conference fee 200 euro; after May 5 - conference fee 260 euro)

Student participant (payment before May 6 - conference fee 140 euro; after May 5 - conference fee 190 euro)

1.9 Do you have a paper to be covered by this registration? *

Yes

No