Sliding dynamics: the physical and mechanical viewpoints on Friction

Registration

Online registration speeds up the registration process but for administrative purposes we also need this registration form to be signed by a lab or group manager.

Send this for by fax +33 5 57 35 58 01 or mail (address below) before october 2 2006 to

CNRS Délégation Aquitaine Limousin

Service du Personnel et des Ressources Humaines - Bureau Formation

Esplanade des Arts et Métiers

33402 TALENCE CEDEX

FRANCE

Registration will be confirmed by mail.

Contact for organisation & logistic :

Angelique CUZON,

mél : angelique.cuzon@saint-gobain.com,
tel: 01 48 39 57 50, fax: 01 48 39 55 62
Contact inscriptions :

Stéphanie ROUGIER,

mél :Stephanie.Rougier@dr15.cnrs.fr

tél : 05 57 35 58 08 fax : 05 57 35 58 01

Gender

Family (Last) name:

First name:

Laboratory or Company

Tél.

Fax.

Web page:

E-mail

For CNRS employees only

N° Agent

Délégation

Grade

BAP (pour les ITA)

Section du CN (pour les chercheurs)

Année de thèse pour les doctorants rémunéré par le CNRS

Post-doc, rémunéré par le CNRS

Année d'obtention de la thèse :

For Non-CNRS people

University/Company

Status

PhD student in

year of thesis

Post-doc

Date of the thesis :

For the attendees working in a CNRS Laboratory

Département scientifique

Code labo

For Non CNRS attendees

1. You registration will be paid by your laboratory/company

Administrative contact.

Family Name First Name

Tel.

Fax.

Mel.

2. If you pay directly

An invoice will be sent to you.

Keywords to describe you scientific activity:

If you want to present a poster, give the title below.

Title of the poster:

If you are a student, fill in the line below:

Name of the thesis adviser:

Registration fees (euros)

Rate	Student	Academic	Industrial
	250	400	600

For CNRS employees, the registration fees are covered by CNRS "Formation Permanente". In addition, travel expenses can be covered by The "Formation Permanente" of the "Délégation CNRS" of their institute, that they should contact .

The registration fees include:

The participation to the summer school;
The full board lodging at "Valpré" where the lectures take place.

Lodging:

Single rooms are provided for "Academic" or "Industrial" attendees and shared rooms for "students".

Registration rate:

I apply for the rate:

Payment:

Bank transfer

Bon de commande (CNRS, Université, Company) ->Please send it with the registration form.

Covered by CNRS ( CNRS agents)

Credit Card (Visan Eurocard)

Other

Please note that for people choosing to send a "Bon de commande", this paper should be sent with this registration form (by fax or regular mail).
If you pay by check, visa card or bank transfer, an Invoice will be sent to you later.

Other remarks:

When you have completed the form, click the "Start Submission" button below. This will generate an e-mail to the registration office (this can cause a warning on your webbrowser). This does notcomplete the registration. You have also to print this page, sign it, and get the signature of the head of your laboratory (or department). Remember to join a "bon de commande" if you want to use it.

Date:

Place:

Signature of the candidate:

Date:

Place :

Signature of your "Correspondant formation" if there is one in your laboratory.

Date:

Place:

Signature of the Head of the laboratory

Print the form to sign it !