Lattice '99 - Registration Form

Please use this form to register for the Lattice '99 conference and to receive further conference mailings. While we will also accept email with the same information, electronic submission of this web form is strongly preferred. In any case, only those returning a registration form will be sent further conference information. The deadline for registration and abstract presentation is April 29, 1999.

Last Name: (required)
First Name: (required)
E-mail: (required)
Institution: (required)
Address (required):

Phone:
FAX:

If you plan to bring one or more companions to the conference, please complete the following:
Number of companions, excluding yourself:

Companions are welcome to participate in the conference social programme and at the conference banquet. Payment for companions should be included with the registration payment.
How many, excluding yourself, plan to participate in
the conference excursion?
the conference banquet? adults + children

You plan to reach Pisa
by air (landing at Pisa airport);
by train;
by bus;
by private car.

Are there any special requirements or comments you would like to bring to the attention of the Local Organising Committee? For example, special dietary needs or requests for non-standard audio-visual equipment.

I hereby authorize the Organizing Committee to process, make use of, and transmit further the personal information provided by me, in accordance with the forms and methods set down by Italian law, and for the sole purpose of activities connected with the organization of the Conference on Lattice Field Theory. Con la presente autorizzo il Comitato Organizzatore al trattamento, all'uso ed alla diffusione dei dati personali da me trasmessi, nelle forme e nei modi previsti dalla legge, ed esclusivamente in riferimento alle attività connesse con l'organizzazione di conferenze di Lattice Field Theory.

If your submission is successful, you should promptly receive an acknowledgement by email.

For registration fees information, refer to the registration page.

Massimo Campostrini, campo@mailbox.difi.unipi.it

Back to Lattice '99 Home Page Last Updated: March 5, 1999