SECOND WORKSHOP ON BINARIES IN THE SOLAR SYSTEM WASOWO PALACE NEAR POZNAN, POLAND JULY 13-16 2010 Please return by text email to agn@amu.edu.pl binaries2@boulder.swri.edu aostaszewska@wasowo.pl ------------------------------------------------------------------- FORM ONLY FOR WORKSHOP PARTICIPANT NAME ______________________________________________ INSTITUITION ______________________________________ MAILING ADDRESS: ___________________________________________________ ___________________________________________________ ___________________________________________________ COUNTRY ___________________________________________ TELEPHONE ________________________________________ FAX ______________________________________________ EMAIL ADDRESS _____________________________________ ------------------------------------------------------------------ ROOM RESERVATION: go to the Lodging Page to reserve a room Date of arrival: Date of departure: I plan to use the shuttle bus/car from/to the Poznan airport or railway station. (cost not included in registration). Yes-- No -- ------------------------------------------------------------------- I plan to attend the informal reception on Monday evening (12.07.2010) Yes-- No -- ------------------------------------------------------------------- I plan to attend the banquet on Tuesday evening (13.07.2010) (cost of banquet is 35 Euro, is not included in registration fee, and will be collected at the workshop) Yes-- No-- ------------------------------------------------------------------- I plan to take part in the trip to Morasko meteor craters and dinner in the Poznan Old Town on Wedensday afteronoon/evening (14.07.2010) (transportation to Poznan Wednesday is included in the registration fee, but Wednesday dinner in Poznan is NOT included) Yes-- No -- ------------------------------------------------------------------- Please indicate if you prefer vegetarian meals: Yes-- No -- ------------------------------------------------------------------- PARTICIPANT Registration fee of 140 Euro will cover coffee breaks, Monday evening reception, meeting rooms, printed materials, bus to Morasko and Poznan Old Town for the Wednesday tours, etc. Payment should be made by FAX and credit card using the link to the Payment Form on the previous page. Form should be signed and sent by fax to: +48 61 829 2772. Altenatively, deposit can be made directly to this bank account: PKO BP S.A. II O/Poznan PL92 1020 4027 0000 1502 0034 2394 Swift code BPKOPLPW Tile of payment: Binary Workshop Receipt will be available at the registration desk during the workshop. ------------------------------------------------------------------- Proposed Title of Presentation: __________________________________________________ Guidelines for abstract submission will be avialable soon. ===================================================================