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             ModSim'99 - BioMedSim'99 
          Noisy le Grand 20-22 April 1999
           Preliminary Registration Form
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Last Name:____________First Name:___________MI:___
Affiliation ______________________________________
Department  ______________________________________
Street Address/PO Box ____________________________
City _______________________ State/Prov. _________
Postal Code ________________ Country _____________
Phone ____________________ Fax ___________________
E-mail ___________________________________________
Society Membership _______________________________

I am interested in
___ BioMedSim'99 Conference
___ ModSim'99 Workshop

I plan to:
___ attend the conference.
___ present a paper.

Title of the paper:________________________________
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I suggest that you send this call for paper to:
Last Name:____________First Name:___________MI:___
Affiliation ______________________________________
Department  ______________________________________
Street Address/PO Box ____________________________
City _______________________ State/Prov. _________
Postal Code ________________ Country _____________
Phone ____________________ Fax ___________________
E-mail ___________________________________________

Please mail, e-mail or fax this form to:
   Prof. Y. Hamam
   ESIEE
   Cite Descartes BP 99
   2 Bd Blaise Pascal
   F 93162 Noisy le Grand CEDEX
   FRANCE
   Tel:  (33) 1-45 92 66 11
   Fax:  (33) 1-45 92 66 99
   E-mail: hamam@esiee.fr