Registration Form

Please fill in and sign the following registration form, and send it by fax or physical mail (not by e-mail) to the following address.

Deadline is FRIDAY 19 MARCH 1999.

	ANTIPODES 99 c/o 
        Peter Schuster
        Ludwig-Maximilians-Universität-München 
	Mathematisches Institut 
	Theresienstr. 39
	D-80333 München
	Germany

	phone : (00 49) (0) 89 2394 4401 
	fax:    (00 49) (0) 89 280 5248
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		 ANTIPODES 99  Symposion REGISTRATION FORM
		 =========================================

Last Name:
First Name:
Affiliation:

Accompanying person(s):
Last Name:
First Name:

Street Address:
City & Postal Code:
Country:

Phone(s):
Fax:

Electronic mail:

Arrival Date:		

Departure Date:		

Number of overnight stays:

Accommodation (breakfast included):
-----------------------------------
Single (45000 ITL) or double room (32500 ITL):

If appropriate, name of the person you want to share your room with:



Since the number of single rooms is very limited, please choose "single" 
only if you definitely need a single room, and tell us 

--- whether you would accept a double room 
    used as a single room (65000 ITL) (yes/no):

--- whether you would accept external accomodation 
    even at a higher rate (yes/no): 

Access/Dietary restrictions:
----------------------------

Meals:
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Everybody who wants to have meals in the VIU cafeteria (that is the 
only place to go on the island) has to opt for a full weekly meal plan 
which has to be paid in advance (ITL 88000/person for ten meals, that is
from Monday to Friday, lunch and dinner each day, including drinks and coffee).  People arriving late, departing early, or intending to attend the conference dinner might book a reduced number of meal coupons (ITL 8800/meal and person). Note that meal coupons cannot be reimbursed upon departure. Please choose:

Full meal plan (yes/no):  

Number of meals requested (empty space treated as 0): 

Accompanying person:

Full meal plan (yes/no):

Number of meals requested (empty space treated as 0): 

Conference Dinner:
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On Tuesday there will be a conference dinner (approx. 50000 ITL/person,
including happy hour, water and wine, and after-dinner coffee). Please tick: 

Yes:                   No:

Accompanying person:
Yes:                   No:

Talk
----
Yes:                   No: 

Duration (25 or 50 minutes): 

Title of the talk (max 15 words):





In case you want to give a talk, please submit an abstract (max 150 words),
preferably in plain LaTeX body text and via e-mail to  
 
antipode@rz.mathematik.uni-muenchen.de

Deadline for registration (by fax or physical mail, but not by e-mail) 
and for the submission of abstracts (preferably by e-mail) is FRIDAY 
19 MARCH 1999. 





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     Date                              Signature
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