14th International Freight Pipeline Society Symposium
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| 14th International Freight Pipeline Society Symposium 29 June-1 July 2011 INDICATION OF INTEREST FORM Please complete this form and return as soon as possible (before 31 December), to: Álvaro Ramírez BIPREE Research Group, Escuela Universitaria de Ingeniería Técnica Industrial, Universidad Politécnica de Madrid, Ronda de Valencia 3, 28012, Madrid, Spain, Fax: +34(0)91-336 56 25, E-mail: alvaro.ramirez@upm.es Title: □ Prof. □ Dr. □ Mr. □ Ms. □ Mrs. First Name*: _______________________________________________________________ Last Name*: _______________________________________________________________ Affiliation: __________________________________ ______________________________ Position: __________________________________________________________________ Preferred mailing address: □ Work □ Home Address:___________________________________________________________________ City: ______________________________________________________________________ State: _____________________________________________________________________ Postcode:__________________________________________________________________ Country: __________________________________________________________________ Phone: _____________________________________ ______________________________ Fax: ______________________________________________________________________ Email*:____________________________________________________________________ *Mandatory Field □ Please send me further information on the 14th International Freight Pipeline Society Symposium. □ I am interested in attending the Symposium. □ I intend to submit Paper and/or Poster abstract/s to be considered for the Symposium program: □ Paper/s and/or □ Poster/s. □ I am interested in attending Technical /Cultural Tours. □ Pre-symposium Technical/Cultural Tour and/or □ Post-Symposium Technical/Cultural Tour. Signature: _________________________________________________________________ Date: _____________________________________________________________________ |
