====== Registration form ======
**10th  WORKSHOP ON MAGNETIC RESONANCE IMAGING AND SPECTROSCOPY (MRI/MRS) APPLIED TO LABORATORY ANIMALS**

//November 29th - December 2nd, 2016//


<WRAP rightalign>
[[ inscripcion_cursomri | versión en castellano]] | [[ formulari_curs_mri_mrs | versió català]]
</WRAP>

<form>
Action mail silvia.lope@uab.es

Thanks "Thanks for submitting your data. We will contact you shortly."

Fieldset "PERSONAL DATA"

static "Fields labeled with a star (*) are required."

Textbox  "First name" ^

Textbox  "Last name" 

email "E-mail address"

Textbox "Phone"

select "Category" "Professor|Researcher|Technician|Post-Doc|PhD Student|Undergrad Student|Other"
Textbox "Other"!


Fieldset "COMPANY DATA"

textbox "Institution/Company" 

textbox "Address"

textbox "." !

textbox ".." !

fieldset " SUPERVISOR "

textbox "Full name"

email "e-mail address"

static " "

Fieldset "BILLING INFORMATION"

select "Registration fee" "Standard: 2.100€|Public University or Research Institution: 1.400€|PRUAB member: 1.100€|UAB member: 800€"

static "1.- If UAB member:"
Textbox  "Cost center"! 
Textbox "Gestor center"!
Textbox "Principal Investigator of the cc"!
static " "

textarea "2.- Others, send invoice to (name/company, DNI/CIF, full address):" "x5" !

static "Registration fee includes handouts and all cost for materials needed during the workshop"


fieldset " PREVIOUS TRAINING ON MRI/MRS"

select "Knowledge level on MRI/MRS" "None|Low|Average|High"

static " "

textarea "Briefly describe your previous experience and/or list MRI/MRS courses attended:" "x5" !


fieldset ""

textarea "Briefly describe your research subject and areas of interest:" "x5" !


fieldset ""
static "Workshop limited to 4 participants (first come first served)"
static "Registration deadline: November 14th, 2016"
submit "Submit your data"

</form>