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REGISTRATION BROCHURE

IV CONGRESS AND V GENERAL MEETING OF THE SMBC

NAME________________________________________________________________

INSTITUTION_________________________________________________________

ADDRESS_____________________________________________________________

______________________________________________________________________

______________________________________________________________________

PHONE_____________________________________FAX______________________

E-MAIL_______________________________________________________________

MEMBER OF THE SMBC: YES ( ) NO ( ).

CURRENTLY IS: STUDENT ( ) PROFESSIONAL ( )

PARTICIPATION IN THE CONGRESS:

ATTENDING ( ) ORAL PRESENTATION ( ) POSTERS ( )

SUBJECT OF INTEREST_______________________________________________

COMMENTS:

 

 

 

 

 

 

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Frank Solís

Enlace de la SMBC en Panamá

Encargado del Comité Organizador, IV Congreso

Apartado 10762, Estafeta Universitaria, Panamá, República de Panamá.

Tel (casa): 507-229-5411

Fax: 507-232-5978 .

E-mail: solisf@tivoli.si.edu