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    • IC-PMS 2014
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Pre-registration form

Fill in the pre-registration form in English.
Please double check that the information in the fields here below is correct.

Personal information

Gender Please select Female Male

First name

first letter is upper case

Family name

in capital letters

Email Address

Enter your organization

Univ./Organization

Laboratory/Service

Address

Address (cont'd)

City

ZIP/Postal code

Country

International phone

Registration questions

Tarification Please select Full registration Student Organizing committee Invited speaker Accompanying Person

I wish Please select a poster presentation an oral presentation no preference

Dietary Restrictions

ie. Allergies, religious/cultural traditions

Permission to IC-PMS to publish photos in which I appeared

Yes No

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