Form Page: resestration

Family Name:

First Name:

Country:

Organization:

Position:

Address:

Tel (Office):

Fax:

Mobile:

Tel (Res):

E-mail:

I am interested in submitting abstract entitled:

For Oral Presentation

Poster

I am interested in Cultural Program, please circle or

Mon 29 Nov

Tues 30 Nov

Wed 1 Dec

Thur 2 Dec

Cairo Sightseeing, Fri 3 Dec

Alexandria Sightseeing, Sat 4 Dec

Accompanying Persons

yes

No. of Persons:

Relevance to Participant:

Please E-mail to:
materials@cmrdi.sci.eg and/or materials_minm@yahoo.com
Fax : (+202) 25010639 Tel : (+202) 25010640

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