EPSC2012 –
Application Form for the Europlanet flatrate contribution for Students

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I hereby apply for the Europlanet flatrate contribution for Students.

General Information

 
Mrs. Ms. Mr.            
Last Name: *
First Name: *
Country: *
Email: *
Affiliation: *
Abstract ID: *
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Bank Name: *
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The Europlanet flatrate contribution for Students is for European students (European Union member countries plus Switzerland, Israel, Norway, Iceland, Liechtenstein, Turkey, Croatia, Former Yugoslav Republic of Macedonia, Serbia, Albania, Montenegro, Bosnia and Herzegovina, Faroe Islands) who have paid their conference registration fee and have an accepted abstract.