EPC_2012 Registration Form

5th Environmental Physics Conference

24-27 Sept. 2012, Cairo, Egypt

Registration Form

Please complete, submit, fax to +(202)22876031, or mail to: Prof.Dr. M.N.H.Comsan, Atomic Energy Authority, 3 Ahmed Elzomor str., Nasr City, Cairo, Postal Code 11787, Egypt.


1. Surname:	First name(s):
2. Nationality:	Gender(M/F):

3. Affiliation:

4. Address:

5. Phone: Fax:

6. E-mail:

5. Phone:	Fax:

7. Title of submitted contribution:

8. Author(s) (Please underline the name of the speaker):

9. Date of arrival: Date of departure:

10. Hotel class requested (for non-Egyptians) in Euro (30-50-80-120):

11. Date: Signature:

9. Date of arrival:	Date of departure:

11. Date:	Signature:

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For problems, suggestions, or questions, please contact Conference Chairman

Last updated: 29 Feb. 2012