Workshop registration

Worshop information

• Place: McGovern Institute for Brain Research, MIT, Boston, USA

• Date: April 27-28, 2012

Participant registration

• <<HTML(<div id="bst_table" style="">

  • <FORM METHOD="post" ACTION="workshop_boston2012.php" name="regform">

    • <TABLE>

      • <TR><TD align=right>First name * </TD> <TD><INPUT type="text" name="firstname" size=40></TD></TR> <TR><TD align=right>Last name * </TD> <TD><INPUT type="text" name="lastname" size=40></TD></TR> <TR><TD align=right>Title / Occupation * </TD> <TD><INPUT type="text" name="title" size=40></TD></TR> <TR><TD align=right>Institution * </TD> <TD><INPUT type="text" name="institution" size=40></TD></TR> <TR><TD align=right>City * </TD> <TD><INPUT type="text" name="city" size=40></TD></TR> <TR><TD align=right>Email address * </TD> <TD><INPUT type="text" name="email" size=40></TD></TR> <TR><TD align=right>Phone </TD> <TD><INPUT type="text" name="phone" size=40></TD></TR>

    • <TR><TD><I>(*) required fields</I></TD></TR>

      • </TABLE>

    <BR> <BR> <INPUT type="submit" value="Register" style="width:100px"> <A HREF="??"> View list of registered participants </A> <BR><BR><BR> </FORM> </div>)>>