Registration form

22nd Evolutionary Biology Meeting at Marseilles

September 25-28, 2018 – Marseilles, France

REGISTRATION FORM
(All the items are compulsory)

Date of submission: dd/mm/yy

Presentation abstract submitted for (please, conserve only the type of your presentation):
□ Poster only
□ Poster with fast presentation
□ Talk

Title of presentation: …………………………………………………………………………………………..
Personal details:
First Name (s):
Surname:
Title, academic degree (Mr., Mrs., Ms., Dr., Prof., Director…):
Student: □ Yes □ No
Laboratory/University/Affiliation:
Address:
ZIP Code:
City:
Country:
Direct phone (daytime):
E-mail:

PAYMENT
(All the items are compulsory)

□ Cheque (only euros cheques)
□ Order Form
□ Bank Transfer

Owner of account: ……………………………..
Address of owner: ……………………………………….

N.B.:
1) Students have to provide a justification (a copy of 2017-2018 Student card, a letter of PhD Director…) or they will be considered as academics.
2) If co-authors would like to come, they also have to fill in a registration form and to forward payment.
3) For administrative reasons, payment is due before the thirtieth day following the abstract and registration form submission.
4) If you need an invitation letter for a Visa, please ask us as soon as possible.

The decision concerning acceptation of the submitted abstracts will be provided as soon as possible.