Seminaire Sophus Lie
                           June 11-12, 2004
                          Universite de Metz

                          REGISTRATION FORM
                             Text Version

Please fill out the registration form below and mail it to: 
pasquale@math.univ-metz.fr or wurzbacher@math.univ-metz.fr

Name:
Affiliation:
Email:
________________________________________________________________

Arrival/departure information

Arrival:  /06/04
Departure:  /06/04
________________________________________________________________

Conference dinner reservation:

I WILL/WILL NOT take part to the Friday evening conference dinner

I will be accompanied by 0/1/2 persons

Special meal requirements:
_________________________________________________________________

Short communications (not for invited speakers):

I would like to give a 30-minute talk: Yes/No
Title:
Abstract: 

_________________________________________________________________

Accomodation information (not for invited speakers):

Option 1
Please reserve for me a single/double/double(2 beds) room 
at the Hotel:
with breakfast: YES/NO (number of people having breakfast:  ) 
for the nights indicated below

Option 2:
Please DO NOT make additional reservation because I will 
be sharing a room with some other participant.

Option 3:
Please DO NOT make any reservation for me

Other: