International Field Symposium of the Peribaltic Working Group 2019 
07–13 September 2019, Greifswald, Germany
Preliminary registration form

Please fill in this form to send it per E-mail to peribaltic@uni-greifswald.de before 20 March 2019!

Ms. or Mr.:					Title(s):
Surname:
First name(s):
Institution:
Street & Number:
Postal (zip) code: 		City:				Country:
Phone:
Fax:
E-mail:
Optional data for invoice (e.g. tax number, NIP etc.):

[  ] I intend to take part at the International Field Symposium of the Peribaltic Working Group in 2019  that will be held in Greifswald and northeastern Germany from the evening of 7 September to the morning of 13 September 2019. 

Conference fee (money transfer until 15 May 2019):
[  ] Students, PhD-students: 420.00 € (please enclose a copy of proof or send separately)
[  ] all others: 470.00 €

Oral presentations and posters (abstract submission until 15 May 2019):
Fill in whether you like to present a talk (20 min. incl. discussion) and/or a poster (A0 portrait format) and the title. Please follow the instructions for abstract submission.
[  ] I intend to perform an oral presentation. Please list all authors and the title: 

[  ] I want to present a poster. Please list all authors and the title:

Special funding of the Greifswald University:
[  ] I apply for financial support for scientists and PhD students from Poland, Latvia, Lithuania, Estonia, Belarus and Russia. I will send my financial support scheme application via e-mail to Sebastian Lorenz (sebastian.lorenz@uni-greifswald.de) before 20 March 2019.

Visas and cover letters:
[  ] I need an invitation letter to obtain a visa for Germany. I will send my request including a passport copy and required information via e-mail to Andreas Börner (Andreas.Boerner@lung.mv-regierung.de) before 15 May 2019.