Participant's Data Form

First name* :            ……………………………               Family name :……………………………

Gender :……………………………                                  Date of birth :……………………………

Nationality** :……………………………                        Address :……………………………         

Telephone :……………………………                             Email :…………………………… 

Employer name and address :…………………………………………………………………………   

Current position :…………………………………………………………                    

Title of paper: ………………………………………………………………………………………

Language of oral presentation :……………………………    

Support needed for presentation (Datashow, etc.) : Please specify………………………     

Expected date of arrival to Luxor :……………………………          

Expected dateof departurefrom Luxor :…………………………… 

Do you needhotel reservation in Luxor ? ……………………………………………………       

* In case of mutiple authors, the form has to be filled only by the scholar who will come to Luxor to present the paper. If the other author(s) want(s) to come to Luxor, they have to mention « only assist » in their application.

** Please attach a photocopy of passport.