Registration via fax

Registration form - area

Your registration for Fechner Day 2001 can be done with this fax form. After successful registration (validation of transmitted data) you will receive confirmation via email, whithin which you will find your entered data. Changing your registration data can be done under Change your data. Here, you will have to enter your registration key (given to you in the confirmation email).

Institut fuer Allgemeine Psychologie

Fechner Day 2001

Seeburgstrasse 14-20

04103 Leipzig

Germany

fax: ++49(341) 9735969

Items with a (*) have to be entered !

First name: *

Surname: *

Telephone:

Fax:

Email: *

Address: *

Country: *

Postcode: *

Institution:

Kind of payment: *

ISP Membership already paid ?*

[100 DM] YES:NO:

Student stipend donation:

Sponsoring for scientists from Eastern Europe and Russia:

Sightseeing Dresden:

YES:

NO :

Cardtype: *

Cardnumber*:

Cardholder (Fullname):

Expiry date*:

Total

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