Workshop on Heavy Quark Physics in Nucleus-Nucleus Collisions

Event Registration Form:

Name:

Affiliation:

Hotel Choice:
Yes, I request a room at the UCLA Guest House ($139 per night)

Arrival date:_____________Departure Date:________________

You will be notified if a room is reserved for you.

I will make hotel arrangement myself

Registration Fee: $100

Yes, I will pay cash upon registration at the workshop

I will mail a personal check (payable to U.C. Regents) to workshop coordinator

Ms. Mary Jo Robertson
Department of Physics and Astronomy
UCLA
P.O. Box 951547
Los Angeles, CA 90095-1547

Additional Workshop dinner ticket ($40 each)

Workshop dinner choices:
Fish Meat Poultry Vegetarian

All workshop talks will be invited. But we will select some talks from contributions. If you wish to submit a talk proposal:

Title:

Abstract:

Presented by: