Application Form to the DPG-School on

Quantum Gases in Dilute Atomic Vapour

Physikzentrum Bad Honnef, March 28th - April 1st, 2011
First name:
Last name:
Gender:
Institution (maxlength=65):
Institution will show up on your
name badge: "First Name, Last Name, Institution"
e-mail:
Phone:
DPG Membership Number
Date of birth (dd.mm.yyyy)

Postal Address
co1
co2
Street
City
zip code
Country

The following cost has to be transferred to the DPG account after confirmation of your participation:
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
any additional information, i.g. vegetarian