APPLICATION FORM



POSSIBILITY OF APPLICATION UP TO 29th FEBRUARY 2012.

Registration on the 34th Polar Symposium is already open.
We invite you to complete an electronic application form
Application deadline is 29. February 2012.
After deadline higher registration fee will be applied.


Name*:
Surname*:
Academic degree*:
Institution/College*:
 
Address*:
E-mail *:
 
Title of the presentation*:
Form of the presentation *:
Choose your panel*:
Accommodation*:
14/15 June 2012
Accommodation *:
15/16 June 2012
Accommodation*:
16/17 June 2012
Place of accommodation*:
Lunch*:
14th June 2012
Lunch*:
15th June 2012
Lunch*:
16th June 2012
Breakfast*:
15th June 2012
Breakfast*:
16th June 2012
Trip around the Silesia*:
16th June 2012, afternoon
 
* - fields marked with asterisk are required