Self-assembly in Life and Materials Science

First name *

Last name *

Email *

University/Company etc.

Department

Country

Type of participant

PhD / Master student, 2400 SEK

Regular participant 3900 SEK (not a member of the Swedish Chemical Society, Kemisamfundet)

Regular participant 3400 kr (I am a member of the Swedish Chemical Society, Kemisamfundet)

To become a member of the Swedish Chemical Society (Kemisamfundet), please visit kemisamfundet.se

I would like to have lunch on the following days

Day 1

Day 2

Day 3

I don't want lunch

I will participate at the dinner on the 5th of November

YES

The dinner will take place at AF-borgen, in central Lund.

Allergies / Food preferences

I would like to bring a poster

Yes

No

Preliminary poster title

Complete invoice address:

Electronic invoice reference number (for Swedish Universities)

Other information: