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Title:
First Name:	(*)
Last Name:	(*)
Email Address:	(*)
Phone:
Fax:
Affiliation:	(*)
Mailing address:	(*)
Type of contribution:	Invited talk Poster None (*)
Title of the contribution:
Include your abstract into the Latex template:	\documentclass[12pt]{article} \pagestyle{empty} \renewcommand{\baselinestretch}{1.3} \topmargin 6 cm \oddsidemargin -0.5 cm \textheight 18 cm \textwidth 15 cm \begin{document} \centerline{\bf THIS IS THE TITLE OF MY PAPER} %\centerline{\bf THAT GOES ON AND ON AND ON} %\centerline{\bf BUT NOT LONGER THAN THREE LINES} \vspace{1pc} \centerline{ Author 1 $^a$, Author 2 $^b$, Author 3 $^{c,d,f}$ and so on} \vspace{1pc} \noindent { $^a$ \it Address of Author 1}\\ \noindent { $^b$ \it Address of Author 2 (if different from a)}\\ \noindent {$^z$ \it and so on (if different from above)} %PLEASE SUPPRESS UNNECESSARY LINES OR COPY AS MANY AS YOU NEED \vspace{2pc} This is the summary of our work, that we are compelling to fit into one A4 page. \end{document} (*) required fields

Please note that the registration process consists of two steps: 1) submission of the online form and 2) payment of the registration fee (see below for details). Unless you choose credit card payment, we need a statement of your bank transaction to finish the process, so we kindly request that you fax or email the following information:

- Your name

- Date of the transaction and amount

- Your bank

- Transaction number or code

Thank you very much for your cooperation.

Please note that the Conference budget does not include support for travel expenses. Pending the success of various applications for funding, we hope to provide some limited help for registration and living expenses for a few participants, especially young researchers and/or scientists from developing countries. Those requesting financial help please fill in the box below; we shall answer as soon as possible (after September 10).

The registration fee -250 us$ before September 10, 300 us$ after September 10- includes: conference material and abstracts book; volume of the conference proceedings; welcome reception on Sunday, December 4; Conference dinner on Thursday , December 8; lunch from Monday, December 5 to Friday, December 9; coffee breaks. We can offer you three options to pay your fee after submitting this registration form, as follows:

a) Credit card (only Visa and American express, sorry!)

Print the form, fill in, sign and fax to us.

b) Bank transfer

Wire to:

WACHOVIA BANK

4210 NW 37th Place Suite 100

Gainesville, Fl 32606

Account 2 0000 1573 0949

ABA 0 6300 0021

and fax to us your bank confirmation of the transaction.

c) Check

Make the check payable to FUNDACION JOSE A. BALSEIRO INC. and send the check to:

FUNDACION JOSE A. BALSEIRO INC.

Dr. Angelo Ferrari

3110 NW 75th Terrace

Gainesville, Fl 32606-6204

Phone: (352) 378-3102

Fax (352) 373-6925

let us know by email that you have done so!

Our fax: THE ORGANIZERS-QBMT3- (attn. Dr. Willy Dussel)

Fax No. (54-11) 4576-3357

Are you requesting financial assistance?
yes no

Justification: