Name: Affiliation: Nationality: Name and affiliation on the badge (if different from above): Preferred size of your free WWW T-shirt: S M L XL Street and number: Country: Argentina Australia Austria Belarus Belgium Brazil Bulbaria Canada Chile China Czech Republic Denmark Estonia Finland France Georgia Germany Greece Hong Kong Hungary Iceland India Ireland Israel Italy Japan Latvia Lithuania Luxembourg Malta Netherlands New Zealand Norway Poland Portugal Romania Russian Federation Singapore Slovakia Slovenia South Africa Spain Sweden Switzerland Taiwan Turkey Ukraine United Kingdom USA United States Or if not in the list: Postal code: City: Post distr: Email: Phone: Fax:
Country: Argentina Australia Austria Belarus Belgium Brazil Bulbaria Canada Chile China Czech Republic Denmark Estonia Finland France Georgia Germany Greece Hong Kong Hungary Iceland India Ireland Israel Italy Japan Latvia Lithuania Luxembourg Malta Netherlands New Zealand Norway Poland Portugal Romania Russian Federation Singapore Slovakia Slovenia South Africa Spain Sweden Switzerland Taiwan Turkey Ukraine United Kingdom USA United States Or if not in the list: Postal code: City: Post distr:
Special dietary requirement.
Require special services as disabled attendee.