I plan to attend the ISSRNS 2002 
 Title (Prof, Dr, Ms, Mr,): _______________
Name: ______________________________
____________________________________
____________________________________

Student:  Yes  No 
Address for correspondence: _____________________________________  _____________________________________
_____________________________________
_____________________________________
_____________________________________

Phone: _______________________________
Fax: _________________________________
E-mail: _______________________________

I would like to present a poster 
Yes  No 

I would like to present an invited original talk
Yes  No 

Preliminary title and authors:
_____________________________________ _____________________________________ _____________________________________
_____________________________________
_____________________________________
_____________________________________
_____________________________________
_____________________________________

____________       _____________________   

.       Date                                          Signature