The European Conference
			PHYSICS OF MAGNETISM 99
		21-25 June, 1999	Poznan, POLAND
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			THE ACCOMMODATION FORM
(Below, in the case of positive answer, replace the characters "___"
by "x")

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Name:
Institution:
Address:
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Please, book me 

a single room ___
a double room ___ for the period of:

___ 20/21 June, 1999
___ 21/22 June, 1999
___ 22/23 June, 1999
___ 23/24 June, 1999
___ 24/25 June, 1999
___ 25/26 June, 1999

in a hotel ___
in a student dormitory ___;

(room shared with ...      ).

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I order lunch tickets for:

___ 21 June, 1999
___ 22 June, 1999
___ 23 June, 1999
___ 24 June, 1999
___ 25 June, 1999

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