Surname...................................................
First Name................................................
Experimentalist...............Age.........................
Theorist..........................Age.........................
Institution...............................................
..........................................................
..........................................................
Mailing Address...........................................
..........................................................
..........................................................
E-Mail........................Telephone...................
Telefax.......................Telex.......................
Field of interest.........................................
.................................................................
.................................................................
Companions (please indicate age of children)..............
1)...............
2)...............
3)...............
Required accommodation how many single rooms?......
how many double rooms?......
how many 3 bed suites?......
PLEASE RETURN THIS FORM CAREFULLY FILLED
NOT LATER THAN JANUARY 11, 1999
TO
Claudia Tofani, INFN, Via Livornese 1291, I-56010 S.Piero a Grado (Pisa),
Italy
fax: +39(050)-880317 and +39(050)-880318