Institut für Romanistik

Competence – Function – Variation. Linguistica Coseriana V

International Conference at the University of Potsdam,

October 8 – 10, 2015

1.  Personal information

Name, Surname / :
Titel / : / Prof. ( ) Dr. ( ) Student ( )
Home Address / :
Work Address / :
University / :
E-Mail: / Phone:

2.  Registration and Payment

Please transfer the conference fees to the following bank account:
Account name: Universität Potsdam
Account-No.: IBAN DE09 3005 0000 7110402844 (BIC/Swift WELADEDDXXX)
Bank: Landesbank Hessen-Thüringen
Reference: Linguistica Coseriana V, KZ: 1506600000206 , Participant‘s Name
a) within the registration period until 31 May 2015
( ) Normal: 100,00 EUR
(…) Reduced: 50,00 EUR (Students)*
b) from 01 June on (out the registration period)
(…) Normal: 130,00 EUR
(…) Reduced: 80,00 EUR (Students)*
* Please send a scanned copy of your student's ID
Please send the registration form and a copy of your payment receipt to Ms. Beatrice Voigt, by e-mail: or per Fax: +49-331-977-4193

3.  Other important information

Arrival on / :
Departure on / :
Will you be attending the Warming up (small reception) on October the 07th at 19.00?
yes ( ) no ( )
Will you be attending the Conference Dinner at the Restaurant Drachenhaus on October the 09th at 19.00?
yes ( ) no ( )
to be paid CASH at the Conference Registration Office.
Will you take part in the Social Programme „A guided tour of the New Palace and Park Sanssouci“?
yes ( ) no ( )
Please pay CASH the amount of 7,00 EUR at the Conference Registration Office.

4.  Receipt / Invoice Details (in case you require acknowledgement of registration and payment)

Invoice for ( ) Registration fee ( ) Dinner ( ) Social programme

University:______
Name and Surname: ______
RECEIPT / INVOICE address
Address: ______
Zip Code ______City ______Country ______

Date ______Signature ______

Universität Potsdam
Institut für Romanistik
Am Neuen Palais 10
Haus 19
D-14469 Potsdam / Organisation
Prof. Dr. Gerda Haßler,
Tel.Nr.: +49-(0)331-977-4114
Prof. Dr. Thomas Stehl,
Tel.Nr.: +49(0)331-977-4255