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Brussels International Stick Insect Meeting

Name *

First name *

e-mail *

Are you accompanied? *

YES

yes, with children under the age of 12

This information is necessary to provide you with badges to enter the museum.

Name & firstname of your accompanying person 1

Can you specify those who are under 12 years old? This will allow us to organise additional activities for the youngest. Thank you.

Name & firstname of your accompanying person 2

Can you specify those who are under 12 years old? This will allow us to organise additional activities for the youngest. Thank you.

Name & firstname of your accompanying person 3

Can you specify those who are under 12 years old? This will allow us to organise additional activities for the youngest. Thank you.

Name & firstname of your accompanying person 4

Can you specify those who are under 12 years old? This will allow us to organise additional activities for the youngest. Thank you.

Are you bringing in species for the breeding stocks exchange? (if yes, please send your species list hereunder)* *

YES

*Please send us a table (.xls or .doc document) with the following information (use this e-mail: icoppee@naturalciences.be). For each species please give: Breeder’s name – Genus – Species – PSG Number (if known)

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Brussels International Stick Insect Meeting