Registration form

Registration formular for the Course:

Date/Course title: .................................................................................................................................................

1. Name of participants:

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2. Company/Institute:

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3. Department:

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4. Address:

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5. Telephone and Fax:

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6. E-mail:

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7. Payment: Bank Transfer to:

Berliner Sparkasse (BLZ 100 500 00)
Konto-Nr. 6 5000 7000
IBAN: DE51 1005 0650 0070 00
BIC/SWIFT-Code: BELADEBE

8. Date: 9. Signature:

........................................... ....................................................

Please fax the filled registration formular to Molnar-Institut
Fax-No.: 0049-30-421-559-99