Preliminary Registration Form:

Name:  

 

 

Sex:          Male        Female

Organization:

 

 

Position:

 

Title:

Phone:

 

Mobile:

E-mail:

 

Fax:

 

Title of paper to be presented at the workshop:

 

 

 

Workshop session at which you wish to present the paper:

 

BIODIVERSITY              FIRE               POVERTY              WATER

Abstract of Paper (maximum 100 words):

 

 

 

 

 

 

 

 

 

 

 

Do you want to participate in the workshop excursion on 24 September 2005

  yes     no

 

 

Note:

Please return the attached registration form by 31st August 2005 to the following contact person:

Suwido H. Limin

CIMTROP

University of Palangka Raya

Jalan Yos Sudarso

Palangka Raya 731112

Central Kalimantan, Indonesia

 

Phone: +62 536 3236880

Fax: +62 536 3225728

Email: suwido_cimtrop@yahoo.com