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Registration Form

R workshop: Debugging and package writing

June 9 - 9, 2014




*Mandatory fields

Title *

Occupation Status *

Gender *

Surname *
Given name *
Institution *
Institutional Address
Department *
Address *
City *
Province/State *
Postal/Zip Code *
Country *
Mailing Address (if different from above)
Department
Address
City
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Country
Telephones and WEB
To include a phone number on the American continent, write the code area followed by the phone number. For international phone numbers, write a + before the country calling code followed by the phone number. If there is an extension, write x and the extension number.
Office Telephone *
Home Telephone
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Email address *
WEB address http://

Registration Fees
(non-refundable)

Category * $ CAD
TOTAL $ CAD

Method of payment:

VISA Credit card

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Cardholder Name
Number (16 digits without space)
Expiry Date

 

Further Information

Please enter any further information or explanatory comments which you would like to include with your registration.

If you have completed this form...

 


May 07, 2014, webmestre@CRM.UMontreal.CA