REGISTRATION FORM

3rd German Conference on Trilobites   
Museum fuer Naturkunde Berlin,  8th and 9th October 2016                              
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Name:				

Surname:

Address (private or department):





Phone number: (optional)
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Collector s pieces for the exhibition (optional)
Phone number (urgently required for necessary requests 
on building up the exhibition!)


Number of pieces:     required space: Length:	 cm; width:    cm
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Title of the lecture (optional):






Required time: approx.     	min	

Technical equipment:   LCD projector [  ] Overhead projector [  ]    
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M.Zwanzig, Scheiblerstr.26, D-12437 Berlin Germany; 
szwanzig(at)t-online.de; phone number: 0049 (0)30 53 213 893