III INTERNATIONAL COURSE OF MATHEMATICAL ANALYSIS IN ANDALUCÍA

La Rábida (Huelva) September 3-7, 2007

Previous information to fill in the Form

To enrol the course, you must fill in the next form.

There are a limited numbers of places in La Rábida seat. So the reservation of the place (for those who have asked for it) will not be definitive, until the payment of the inscription rate. The payment must be done by a deposit (or a bank draft) of 115 € to the next bank account:

Nº CCC (IBAN):  ES10.2098.0148.94.0107581982
         SWIFT:  CECA ES MM098

Once we confirm the deposit, you will receipt a confirmation mail and the enrolment will be definitive. Accomodation and maintenance at the residence (150 €) will be payed during the stay in La Rábida.



Personal Data
Name:* Surname:*
Birthday: Sex:*
Nationality: Passport:*

Residence Data
Address:* City:*
ZIP Code:* Country:*

Academic data
University:* Position:
E-mail:* Telephone:
Fax:

Communication
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Accomodation
¿Do you want to stay at the Residence?:*
¿Accompaining person?:
Comments: (Tell us if you want to share room with someone in particular)

(*)=mandatory 
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Última modificación: 16-04-2007
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