Personal registration

Please fill in the following form, to register for the conference. The deadline for registration is set to May 16, 2011. Registration fees are set to 10$, payable on arrival. The ISM will reimburse part of the transport and lodging fees, for those who ask it.

Participants interested in giving a talk during the conference are also asked to send their title and abstract by e-mail, at fiorilli@dms.umontreal.ca, by may 16, 2011.

Last name
First name
E-mail adress
Cycle	Undergraduate : Master student : Ph. D. student : Post-doc. :
Your University	Bishop University Concordia University Université Laval McGill University Université de Montréal Ecole Polytechnique Université du Québec en Abitibi-Témiscamingue Université du Québec à Chicoutimi Université du Québec en Outaouais Université du Québec à Montréal Université du Québec à Rimouski Université du Québec à Trois-Rivières Université de Sherbrooke Other
If other, please specify:
Are you planning to come to the opening activity on friday? (the wine and cheeze party)	Yes No Maybe
Are you planning to give a talk during the conference?	Yes No Maybe
What is yout main branch of interest?	Numerical and/or applied maths Pure/Theorical maths Statistics Other
If you have any particular restrictions (alimentary, allergies or other), please indicate them here.