Registration form                 

VLIZ Young Scientists’ Day
Friday, 31 March 2006 – Provinciehuis Boeverbos, Koning Leopold III-laan 41, 
B-8200 St-Andries Brugge

Name:	Firstname:

Function: 

Institution:

Address:

Tel.:                                            Fax:                                 E-mail : 

		 will attend the VLIZ Young Scientists’ Day 2006

		 will take lunch   		 I am vegetarian
	
		 will present a poster	 a demonstration

entitled: 

                           

authors: 

                         will participate in the photo contest

  enclosed you’ll find my English abstract (max. 1 page, please use template)

Signature:					Date:

To be sent before 20 February 2006 to:
Vlaams Instituut voor de Zee
Wandelaarkaai 7,  B-8400 Oostende 
E-mail: info@vliz.be / Fax: +32-(0)59-34 21 31