Registration form

10th WORKSHOP ON MAGNETIC RESONANCE IMAGING AND SPECTROSCOPY (MRI/MRS) APPLIED TO LABORATORY ANIMALS

November 29th - December 2nd, 2016

PERSONAL DATA

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First name ^* Last name ^* E-mail address ^* Phone ^* Category ^* Other

COMPANY DATA Institution/Company ^* Address ^* . ..

SUPERVISOR Full name ^* e-mail address ^*

BILLING INFORMATION Registration fee ^*

1.- If UAB member:

Cost center Gestor center Principal Investigator of the cc 2.- Others, send invoice to (name/company, DNI/CIF, full address):

Registration fee includes handouts and all cost for materials needed during the workshop

PREVIOUS TRAINING ON MRI/MRS Knowledge level on MRI/MRS ^* Briefly describe your previous experience and/or list MRI/MRS courses attended:

Briefly describe your research subject and areas of interest:

Workshop limited to 4 participants (first come first served)

Registration deadline: November 14th, 2016

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