Registration Form

Registration deadline: November 13, 2003

Given name(s):
Family name:
Affiliation:
Street address:
City:  Zip,index:
Country:
Phone nr:
Fax nr:
E-mail:
Duration of stay: Arrival:   Departure: 
Presentation:
title and abstract
Will attend: NorduGrid Workshop
LHC Physics Workshop
Conference dinner: Yes, will participate
No, will not participate
Special food preferences:  Vegetarian; specify if other:
Hotel preferences:
Check if sharing a room
(double rooms only):		  Sharing with (roommate's name):