/ The Carbon 2015 Satellite Workshop
on Bulk Carbon Materials
Dresden (Germany), July 10-11, 2015 /

Please send this form to or by fax to (+33)5 5684 1225 before March 31st, 2015.

Registration form & invoice for the Carbon 2015 Satellite Workshop:

Multi-scale structure & properties of

Bulk Carbon Materials:

Structure determination, physical & chemical properties characterization, modelling, from nm to m

University of Technology – Dresden, Germany– July 10-11, 2015

Title (Dr, Pr …) & Name:
Institution
Address :
Phone:
Fax :
Email :
I wish to propose a communication: / Oral communication
Poster
(communication proposal form on next pages)

Registration fee: 20 €

Payment by bank transfer only

Please do not forget to mention «PYROMAN» in the payment order

Bank account holder: ASS GFEC

Bank name: CAISSE D’EPARGNE LORRAINE CHAMPAGNE ARDENNES

SWIFT: CEPAFRPP513

IBAN: FR76 1513 5005 0008 0013 4044 447

Bank data(French payments):

Etablissement : 15135 - Guichet : 00500

N° compte : 08001340444 - Clé : 47

Domiciliation: CE LORRAINE CHAMPAGNE-ARDENNE BP23954506 VANDOEUVRE

BIC: CEPAFRPP513

(French only)

N° SIRET Association GFEC :329 714 216 00010

COMMUNICATION PROPOSAL

Title:
Author(s) & affiliation(s):
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Title

A. B. Author1,2, Y. Z. Coauthor3 (please underline the presenting author)

1Affiliation , City, Country

2Other affiliation, City, Country

3Other affiliation, City, Country

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We report results [1] as seen in fig. 1.

Fig. 1: Caption

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[1] Author A.B., Wotsizname T., Title, Journal, vol, pages (year)

[2]Anyguy T., Title, Journal, vol, pages (year)