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Registration: Step 1/3 - Personal Information

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If you do not have an e-mail address or you prefer to register in a 'traditional' way please download here the full registration form (PDF, 240Ko, download here the plugin - those links will be opened in a new window) and submit your registration by post to the address below or send it by fax to +32 2 627 41 41.
Prof. Dr. Th. Backeljau,
Royal Belgian Institute of Natural Sciences,
Vautierstraat 29, B–1000 Brussels, Belgium

Required fields are marked by "Required"

PERSONAL INFORMATION


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(Required)
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(* These names will appear on your Congress Badge)

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Your e-mail address is the primary method of correspondence. All congress updates and notifications will be sent to this address.
Please keep your e-mail address up to date and inform us about any eventual changes by mailing to wcm@naturalsciences.be !

(Required)

PROFESSIONAL / PRIVATE ADDRESS

Provide either your professional address or private address. (Required)
This address will be used for any document you require from us or that we have to send to you.
1. Professional address


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2. Private address (not required if you provide your professional address)

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PRIVACY ACT

If you DO NOT wish to have your name, address and details to be included in the list of delegates please tick here:
 
>> A problem with your data or with this form ? Send a mail to: wcm@naturalsciences.be
 
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