ERCIM  Week 2006
29-31 May, 2006, Budapest, Hungary 

REGISTRATION  FORM

Please, complete this form and submit it as soon as possible to
ERCIM Week 2006 Secretariat

(Marianna Kindl, c/o Conference Department, MTA SZTAKI
H-1111 Budapest, Kende u. 13-17., Hungary, fax: +361 386 9378)

Personal data  (Please print or type)
Please provide information as you wish it to appear on your ERCIM Week 2006 Attendee badge.

 Surname/Family Name	Middle Initial	First Name

 Affiliation

 Institution/Company

 City	 Country

 E-mail	 Phone (incl. country code)	

Special request (vegetarian, disability etc.): ……………………………………………………………………………………….

Please, indicate your participation in sessions and evening programmes:

Board of Directors (30 May) 	 	Board of Directors (31 May) 	 	
Board of Directors Strategy Group	 	Board of Directors Task Group  	 	
Execom meeting	 	Editorial Board Meeting	 	
Familiarization	 	Seminar 	 	
Dependable Embedded Systems WG 	 	Human Resource TG 	 	
BMI WG 	 	PR Meeting 	 	

Lunches:            29 May	       30 May	      31 May	
Dinners:             29 May	       30 May		

Please, indicate if you have any accompanying person participating in the Evening programmes:

 Dinner on 29 May (number of accompanying person(s) ......) 
 Gala Dinner on 30 May (number of accompanying person(s) ......) 

	
   Signature                                                                                       Date