Registration form 2021

Last Name

First Name

Laboratory

Address

Street Address Line 2

Country

Invoice address if different of the laboratory adress :

Phone

Your gender

Email

exemple@exemple.com

To check *

I confirm my attendance to the workshop (22nd to 25th Septembre 2021) I am a student or a post-doc applying for an oral communication (*) I am a regular academical attendee, I will pay 450 € for registration fees I am a regular industrial attendee, I will pay 600 € for registration fees

I submit my abstract

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I am a regular attendee, I will present a poster:

yes no

I will take the bus:

yes no

If yes, please indicate for your arrival on Sept. 22nd

Nantes railway station (15:30) Nantes airport (16:00) Vannes railway station (17:35)

If yes, please indicate for your departure on Sept. 25th

Vannes railway station (13:35) Nantes airport (15:15) Nantes railway station (15:45)

(*) Free registration and travel grant will be awarded to selected oral communication. I understand that if my abstract is not selected, I will have to register as a regular attendee. In this case, I can register until June 30th.

Register form must be send as soon as possible at : francoise.leost@univ-nantes.fr For information of the workshop: www.cgo-workshop-vecto.fr