中国岩石力学与工程学会参加国际会议报名表

No：　　　　　

Form（表格）

请中英文双语填写

The name of congress：                                         

Name (姓名)：                         Sex(性别):       

Day of birth(出生年月)：          /         /           

Title(职称)：                      Duty(职务)：                         

Organization(工作单位)：                                                 

Address (通讯地址)：                                                  

Zip code(邮编)：          

Tel (联系电话)                   (office)              (cell phone)

Fax：                  E-mail:                                

Are you an ISRM member? (是否ISRM国际会员)：YES□,NO□

→I will be an ISRM member(我愿成为ISRM会员)：YES□(500RMB/4years)

Will you want to join the technical tour after the congress organizing by CSRME

(是否愿意参加学会组织的会后考察)：NO□, YES□  _________

护照类型:因公 □    因私□       护照号: _________     

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