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Registration 2018

YOUR INFORMATION
*Civility
*Family name (Capital letter)
*First name
*Nationality
*Company / Institute / University
*Laboratory
*Professional Address
*Zip Code
*City
*Country
*Phone
*Email
Status
INVOICE INFORMATION
Invoice Company name
Invoice Address
Invoice Zip Code
Invoice City
Invoice Country
Order N°
Name (Person to contact)
Phone (Person to contact)
Email (Person to contact)
*Choice of the module :
PAYMENT
*Registration :
Registration : 400 euros
Reduced registration : 150 euros (for Turkish, Russian and Indians PhD students attending module in their country)
Master student from university where module runs
*Type de participant
Invoice date

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Price excl. VAT :
VAT :
Price inc. VAT :