| First name: | |
| Last name: | |
| Gender: | |
| Institution (maxlength=65): | |
| Institution will show up on your | name badge: "First Name, Last Name, Institution"
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| e-mail: | |
| Phone: | |
| DPG Membership Number | |
| Date of birth (dd.mm.yyyy) |
| co1 | |
| co2 | |
| Street | |
| City | |
| zip code | |
| Country |
| Euro 465: full board and lodging at the Physikzentrum Bad Honnef (PBH) |
|---|
| Euro 365: the same for DPG members |
| Euro 305: for students full board and lodging at the PBH |
| Euro 205: for students DPG members full board and lodging at the PBH |
| Euro 205: only full board |