For print in Word

Name                                                                             First name

Academic title/occupation                                          Institution

Phone/Fax                                                                    e-mail

Address

○  Key note lecture (30 min)                                  ○  Short lecture (20 min)

Title of a lecture _____________________________________________________

(Will be translated German/English, English/German)

Technical support needed      ○  yes                     ○  no

Please, specify which one ________________________________________________

Lunch (Fri and Sat)                   ○  yes                    ○  no

  ○  Vegetarian                     ○  Non-vegetarian

Date                                                                               Your signature     

Please submit your abstract until the 1^st of November 2004 via e-mail to daseinsanalysis@seznam.cz or a printed copy to the postal address:

PVŠPS, s.r.o., Bc. Tereza Králíčková

Hekrova 805, Prague 4, 149 00, Czech Republic

For further information please contact: daseinsanalysis@seznam.cz

Tel:  +420607185087

Fax: +420267913634

E-mail: daseinsanalysis@seznam.cz

Address: PVŠPS, Bc.Tereza Králíčková, Hekrova 805, Prague 4, 149 00, Czech Republic