When your accommodation is booked, please email filled out version
of this form to:

Mike Rosner (mike.rosner@um.edu.mt) and
Norbert Fuchs (fuchs@ifi.uzh.ch)


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CNL2010 REGISTRATION FORM

Name


Email


Mobile (in case we need to contact you urgently)


Country


Affiliation (name of institution) 


Affiliation type

[  ]  University or Educational Institution
[  ]  Industry or Business
[  ]  Other      [please specify]


Current Status 

[  ] Student
[  ] Faculty of Academic Employee
[  ] Other Employee
[  ] Other (please specify)

Arriving on (date)


Arriving from (place)


Leaving on (date)


Accommodation booked at 


Reason for wanting to attend CNL 2010



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