ICVPB 2004 MarseilleINTERNATIONAL CONFERENCE ON VOICE PHYSIOLOGY AND BIOMECHANICS - MARSEILLE (France), August 18-20, 2004 -
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Registration form :Please, print the registration form and fill in it then send with paiement to
Laboratoire d'Audio-Phonologie Clinique Fédération ORL - CHU Timone 13385 Marseille cedex 5, France Name:.................................................................................. Surname:.............................................................................. Institution:............................................................................ Adress (including Zip):............................................................. Country:.............................................................................. Phone number and fax:........................................................... E-mail:............................................................................... Abstract submission .........................................................Yes -No Fees ........................................................................... 330 Euros Accompanying person for Gala Dinner (x70 Euros)....................... Euros Total ........................................................................... Euros
Number ..............................Exp date..............
AFROP - Banque Chaix Marseille Prado (France) Account number 10178 - 00018 - 0000010202K - 31 IBAN FR43 1017 8000 1800 001 0202 K31 BIC CHAIFR2A
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Dernière mise à jour le : 01 mai 2004. |