BAIL 2016 Registration (Please email completed form and bank transfer payment documentation to bail2016@csrc.ac.cn)


Title:

First Name:

Last Name:

Country

Arrival Date: 2016/08/

Departure Date: 2016/08/

Email:

Phone:

Registration: Standard / Full-time student

Total Fee Paid:

Number of Accompanying Persons:

Organization:

Address:

Are you giving a talk (Yes/No): 

Special Requirements: equipment, etc.

Number of persons (including you) attending
(a) Welcome Reception:
(b) Conference Dinner: