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Participant Registration Form Ceremonies on the occasion of the 350th Anniversary of the Ivan Franko National University of Lviv foundation 10-11 October 2011 Last Name _______________________________________________________________ First Name ____________________________________________________________________ Patronymic ______________________________________________________________ Organization/Institution________________________________________________________ Position__________________________________________________________________ Contact Telephone / Fax_________________________________________________ E-mail ________________________________________________________ Do you need accommodation assistance (dormitory or hotel) ? ___________________________________ Date and Time of Arrival_____________________________________________________ Date and time of departure ________________________________________________________ Special needs/Requests, Names of accompanying person(s), if any. _________________________________________________________ Please complete the form and email it to lnu350@gmail.com or notify us by telephone (032) 239-40-40. THANK YOU! |