Prethodna prijava / Registration form

Molimo Vas da svoje sudjelovanje prijavite na ovom obrascu najkasnije do 30. studenog 1996. Please complete and return this card by November 30, 1996.

Prezime / Surname :

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Ime / First name :

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Ustanova / Affiliation :

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Adresa / Address :

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Telefon / Phone :

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Fax:

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Zelim prisustvovati Kongresu: I wish to attend the Congress:

• s usmenim priopcenjem / with an oral presentation
• s posterom / with poster
• kao izlagac / as exhibitor
• kao sudionik / as participant

Datum / Date :

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Potpis / Signature :

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