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UQ Quantum Gas Workshop Registration form
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PLEASE REPLACE ALL CAPITALISED TEXT, CUT AND PASTE INLINE, AND SEND TO:
uqqg2012@gmail.com


** Name:
JOE BLOGGS

** Position:
POSTDOC

** Email: 
JOE.BLOGS@UQ.EDU.AU

** Mobile number:
0412 345678

** Institution:
UNIVERSITY OF QUEENSLAND

** Proposed day and date of arrival:
SUNDAY 17 NOVEMBER 2012

** Proposed day and date of departure:
SATURDAY 1 DECEMBER 2012

** I have eduroam access, and I'm sure it works (www.eduroam.edu.au)
YES / NO

** Accommodation (Choose one)
- I would like a room at Women's College
- I will arrange alternative accommodation for myself

** Would you like to be considered for a seminar?
YES / NO

** Brief outline of proposed seminar
MY SEMINAR WOULD COVER THE RELATION BETWEEN SHEEP AND COWS

** Dietary requirements: 
NO FISH, NO MEAT, HALAL, GLUTEN FREE, AND I DON'T LIKE CAULIFLOWER.  I HAVE A NUT ALLERGY.  I WON'T EAT GREEN FOOD.