"; $limite_inscription = "September 30th, 2006"; $sujet_mail = "From Dzero to ATLAS - Inscription"; $from_mail = "riffault@lpsc.in2p3.fr"; $destinataire = array(); $destinataire[0] = "riffault@lpsc.in2p3.fr"; $destinataire[1] = "sajot@lpsc.in2p3.fr"; $destinataire[2] = "Arnaud.Lucotte@lpsc.in2p3.fr"; ?>

REGISTRATION FORM

Thanks to register before :

Last name (capital letters )* :
Firstname :
Name of the Institution :
Address of the Institution :
Phone :
Fax :
E-mail* :
Arrival* :
Departure* :

Lunches
(check the days)

October, 09th: Yes No
October, 10th: Yes No
Social dinner
October, 09th:: Yes No
Special request (ex : vegetarian food...)

* mandatory

Home page
Admin