Registration Form
Family Name : ............................. First Name : .............................
Institution : .............................
Mailing Address : .............................
City : ............................. Country : .............................
Phone : ............................. Fax : .............................
E-mail : .............................
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I confirm my participation in this Workshop : |
|
From (date of arrival) : ........................
To (date of departure) : ........................
Please refer to the "Accommodation" paragraph to confirm your choice :
| |
Hotel La Rotonde |
| |
Hotel Mercure Paul Cézanne (available only from 9 to 20 July) |
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Hotel Residence Les Jardins Mozart |
for ....... person(s) nb of nights : ..... Single room/Studio double room/T2
The following information is necessary to enter the Cadarache Site
(Have your passport or I.D. Card with you the day of the visit).
For each visitor :
Date of birth : ______________________________________
Place of birth, country : ______________________________________
Nationality : ______________________________________
Passport or Identity Card Nr : ______________________________________
Home Address : ______________________________________
Please enclose a copy of your passport if you are not an European Citizen.
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Please return this completed form before February 15th, 2001 to :
Véronique POLI, Association EURATOM - CEA
DRFC/SIPP/GCED - Bt. 506 - CEA/Cadarache
F-13108 Saint Paul-lez-Durance, Cedex. France
Fax : +33 (0)4.42.25.62.55 - E-mail : v.poli@cea.fr
