Second Göteborg Conference in Harmonic Analysis

and Partial Differential Equations

June 4-10, 2001
Dedicated to the memory of Björn E. J. Dahlberg
 

REGISTRATION FORM

Name ................................................................................................................
Address  ................................................................................................................
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E-mail ...............................................................................................................
University & Department ...............................................................................................................
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Accompanying person (s) (an extra registration fee of 200 SEK/adult)
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Arrival Date:.........................................................Time:.....................................
  Means of arrival:.....................................................................................
  Flight (train, bus, boat) coming from:........................................................
  Flight number:.......................................................................................
Departure Date:.........................................................Time:....................................
  Means of departure:...............................................................................
  Flight (train, bus, boat) to:......................................................................
  Flight number:........................................................................................
I shall be staying at: ..............................................................................................................
I wish to participate in the sea excursion on June 7
yes........................... no..............................
Special food requirements ...............................................................................................................

I wish to give a short talk (20-30 minutes)
yes........................... no................................
Brief summary ................................................................................................................
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Payment: the registration fee is 800 SEK before April 30, 2001, and 1000 SEK after that date.
  • I wish to pay by credit card (please use fax or mail to send in the form):
VISA........................... number............................................
MasterCard.................. number............................................
Eurocard...................... number............................................
Cardholder........................................................................................
Expiry date........................................................................................
Signature............................................................................................
  • I wish to use bank transfer:......................
Please pay the money to bank account nr 5439 10 323 09. Recipient is Göteborg University.
Swiftcode: ESSE SESS
Skandinaviska Enskilda Banken, S-106 40 Stockholm
Please refer to "Second Göteborg Conference in Harmonic Analysis and Partial Differential Equations" and to ref A3043. Do not forget to indicate your own name.
  • (For Sweden only!) I wish to use postgiro transfer:......................
Please pay the money to Swedish postal account nr 156 27-3
Swiftcode: PGSI SESS
Postgirot bank, 105 06 Stockholm
Please refer to "Second Göteborg Conference in Harmonic Analysis and Partial Differential Equations" and to ref A3043. Do not forget to indicate your own name.
  • I wish to pay cash on arrival (1000 SEK)..........................
  • Please note that we cannot accept payment by cheque.