Croatia Author Workshop 2013_April

Registration Form

May we kindly ask you to submit this registration form before Monday, 16th April 2013.

If you have any problems, please contact:

Agata Jablonka, Customer Development Manager
Email: a.jablonka@elsevier.com
Phone: +49 172 6273 978

	Yes	No
Thursday, 18th April 2013 , University of Zagreb	Thursday, 18th April 2013 , University of Zagreb Yes	Thursday, 18th April 2013 , University of Zagreb No

Surname:

First name/ initial(s):

Position/Job title:

Institution:

Address:

Postcode /Place:

Email address:

Phone no: