Chemistry, medicine and crime:
Orfila (1787-1853) and his times

Maó, 19, 20 March 2004

Registration form

Name		.............................................................................................................		
Address	.............................................................................................................

Fax 		.....................................  E-mail	..........................................................

 General Registration (180 Euros) 
 Registration for residents in the Balearic Islands (90Euros) 
 Full Registration * (from Barcelona, 250 Euros)
 
Payment by Standing Order, Cheque or Credit Card to:
Chemistry, medicine and crime: Orfila (1787-1853) and his times
 	"Viatges Magón":

•	Bank Account: La Caixa C/C 2100-1806-40-0200002809
•	Cheque number. .............................................................................
•	Credit Card............. Number.................................  Exp. Date............

Please, send this form to:  

Viatges Magón. 
Avda J. Anselm Clavé, 28, 07703 Maó (Spain)

Fax : 971 351 146 
e-mail: enriqueta@vmagon.es

Full registration deadline: February 15, 2004.

For any other arrangement, please contact the travel agency. 

* It covers a return flight ticket Barcelona-Menorca-Barcelona, three meals and two nights accommodation in a double room.