CASA workshop Registration

Please complete this form to register for the CASA workshop preceding the conference "Molecules in Galaxies". Participation in the conference is not a prerequisite and we must limit the numer of students attending, so we ask you to fill out this form separately.

There is no registration fee for the workshop, but the number of participants is limited to 30.

Note that a separate registration form is required for the conference itself.

Personal Details

Title:
First name:
Last name:
Position:
Institute:
Country:
Full postal address: (max 10 lines of 50 characters)
Email:
Phone:
Fax:


Conference attendance:
Summer school attendance (if held):