BNL eRHIC Workshop

Registration Form


Name (First/Middle Initial/Family):

Title: Mr. Ms. Dr. Prof.
Organization or Affiliation:

Mailing Address:

Telephone: Fax:
E-mail address:

Arrival information:
Date: Time:
Airline: Flight Number: Airport:
Departure information:
Date: Time:
Airline: Flight Number: Airport:

Please make limo reservations for arrival and departure: Yes No

(Please note: we need COMPLETE flight info in order to make a limo reservation.)

On-Site Housing Request:
Arrival Date: Departure Date:

Dorm: Female Male

Other: Single Double, sharing with:

I prefer to make my own reservation at a hotel: Yes No


Further comments about travel and accomodations, if any:


Presentation: Title and Abstract

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The last update was on November 2nd, 1998.