Registration Form

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Prof./Dr/Mr/Ms: _______________  ______________   _______________    

                                     Last name           First name              Other name(s)

Institution : ______________________________________________

Mailing address : 

Phone : _________________________  

Fax : ________________________

E-mail:  ________________________________________________________

Registration method :

                ‡Speaker               Participant

 Type of presentation :

                ‡Oral                     Poster

  Paper title :

__________________________________________________

__________________________________________________

__________________________________________________

__________________________________________________

Payment of registration fees :

                        ‡Cheque                              Bank Transfer

Hurghada trip:

                ‡Yes                       No

 Date: ____________________     Signature :   ________________