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REGISTRATION FORM

For non-speaking participants at the workshop

Workshop on Representations of Lie Algebras

To the Faculty of Mathematics, Fax number 972-8-9344122

First name:

Family name:

Address:

E-mail:

I am a student (yes/no):

I will participate in the conference dinner (yes/no):

If yes. I participate in the dinner with my partner / accompanying person (yes/no):

I will arrange my own accommodation (yes/no):

If no :

Arrival date (____.____). Departure date (____.____).

Please check one of the following:

( ) a room (with bathroom) at 50 $ per night or ( ) a room in a flat at 35 $ per night