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For your registration, please fill in the following form:
Subject:
*
Confirmed registration for the 11th Science of Aphasia conference
Title:
-
Prof.
Dr.
Family name:
*
First name:
*
Accompanying person:
*
no
yes
Affiliation:
*
Address:
*
E-mail:
*
Amount of registration fee that has been paid:
*
Early regular (€160)
Early faculty (€140)
Early student (€120)
Late regular (€190)
Late faculty (€140)
Late student (€150)
Daily ticket (€40/day)
Notes to the organizers:
Spam Protection: Please don't fill this in: