REGISTRATION  FORM

                 for

     DEEP IMPACT AS A WORLD OBSERVATORY EVENT - 
     Synergies in Space, Time, and Wavelength

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A Workshop sponsored by the Vrije Universiteit Brussels and ESO


Date:  Aug 7-10, 2006

Venue: Brussels, Palace of The Royal Academies for Science and the Arts   


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please apologize but this is not an on-line editable form;
you have to complete and send it  by email 
to              csterken@vub.ac.be   
with cc to      hukaufl@eso.org

===================== tear off here     =======================

                   REGISTRATION  FORM
                          for
VUB/ESO Workshop 
	DEEP IMPACT AS A WORLD OBSERVATORY EVENT - 
     	Synergies in Space, Time, and Wavelength


Brussels, Palace of The Royal Academies for Science and the Arts   


Last Name        = 

First Name       = 

Institute        = 

Phone            = +

Fax              = +

Email            = 

Presentation     = Title, type, authors

Arrival          =

Departure        =



Remarks          :  


-------------- vs March 3 2006 -----------------------------------------------