Registration form IVS2017

* required fields *Family Name: *Given Name:
*Affiliation (please mark):
Ariel University
Ben-Gurion University of the Negev
Bar-Ilan University
Holon Institute of Technology
The Hebrew University of Jerusalem
The Open University of Israel
The Technion
Tel-Aviv University
Weizmann Institute of Science
Other academic institute
Other type of organization
*Mailing address:
*Street: *City: *Country: *Postal code: Mobile phone: Work phone: Fax: *E-mail:
*I plan to attend mainly the following sessions (please mark up to 3 options):
Session Nanomaterials: advanced fabrication and characterizationSession Basic and applied surface scienceSession Energy and SustainabilitySession Responsive Surface and ElectrochemistrySession Mechanical Properties and TribologySession Bio-Interfaces, soft Matter and MicrofluidicsSession Nano Electronics and SpintronicsSession Photonics and Plasmonics
*Presenting (please check at least one option):
I do not intend to presentI intend to present an oral presentationI intend to present a poster presentation
*Name to appear on invoice:
*Fees (please mark your status):
Conference & Workshop- Standard - 725 NISConference - Standard - 550 NISWorkshop - Standard - 225 NISConference & Workshop- Postdoc - 500 NISConference - Postdoc - 400 NISWorkshop - Postdoc - 150 NISConference & Workshop- Student/Retiree - 425 NISConference - Student/Retiree - 325 NISWorkshop only- Student/Retiree - 100 NIS
Please mark:
 (optional) I would like to be an IVS member for the incoming year.
*I have read the general terms of the site, and accept them.
*Please enter the numbers: