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\underline{\LARGE {\sc Hirschegg\phantom{,}'95:} \hfill
HADRONS IN NUCLEAR MATTER}\\[0mm]

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APPLICATION FORM
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Hirschegg Workshop\\
c/o Frau E. Rass\\
Gesellschaft f\"ur Schwerionenforschung\\
Postfach 110 552\\
D-64220 DARMSTADT\\
Germany\\[2.0cm]
(\hspace*{3mm}) I shall attend  (number of accompanying persons . . .
)\\[2mm] (\hspace*{3mm}) I shall not attend\\[5mm]
the International Workshop XXIII
on Gross Properties of Nuclei and Nuclear
Excitations at Hirschegg, Kleinwalsertal, Austria, January
16 - 21, 1995.\\[0.7cm]
(\hspace*{3mm})  I like to present a contribution entitled\\[0.6cm]
.\dotfill .\\[4mm]
.\dotfill .\\[3mm]
An abstract (one page maximum) is attached.\\[0.4cm]
For accommodation I prefer\\[0.2cm]
(\hspace*{3mm})  Waldemar-Petersen-Haus (student lodge, preferably for
partipants without accompanying persons, full board, whole week Jan. 15 - 21
must be paid $\approx$ DM 330)\\[2mm]
(\hspace*{3mm})  pension (breakfast only, per person and day $\approx$ DM
55)\\[2mm]
(\hspace*{3mm})  Hotel Ifen (half board, per person and day $\approx$
DM 170)\\[1.0cm]
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Name:       &.\dotfill .&                     &           \\[3mm]
First Name: &.\dotfill .&                     &           \\[3mm]
Institution:&.\dotfill .& \hspace{3mm} e-mail:&.\dotfill .\\[3mm]
Address:    &.\dotfill .&                     &.\dotfill .\\[3mm]
	    &.\dotfill .& \hspace{3mm}  Phone:&.\dotfill .\\[3mm]
	    &.\dotfill .& \hspace{3mm}  Fax:  &.\dotfill .\\
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