REGISTRATION FORM

Note: this form must be carefully compiled in each part. IP Addresses and date/time will be recordered.

Title:
First Name:
Middle Name:
Last Name:

For those who are accompanying a conference participant, please indicate the name of the related conference participant and if you are interested in touristic activities (not included in the registration fees):

Date of birth: Gender:

 

Institution:
Address of Institution:
City: Postal (zip) Code:
Country:
Phone: Fax:
e-m@il:

NOTE1: in order to register yourself, you must have payed the registration fee by bank transfer and have got the payment number ready for notification.

REGISTRATION TYPE

NOTE2: bank charges are excluded from the participation fee. Please, pay all bank fee by yourself.

NOTE3: To the registration fee is necessary to add 12 € for bank charges.

Payment number – Date of payment:

Fiscal code (only for italian participants):

Conference

Early payment (May 31, 2013) Late payment (June 15, 2013)
Regular 710 € 750 €
Reduced 460 €
Accompanying 610 € 650 €

Pre-conference excursion

Early payment (May 31, 2013) Late payment (June 15, 2013)
Regular 350 € 400 €
Reduced 200 €
Accompanying 250 € 300 €

 

Post-conference excursion

Early payment (May 31, 2013) Late payment (June 15, 2013)
Regular 300 € 350 €
Reduced 150 €
Accompanying 200 € 250 €

Abstract submission

I will submit one abstract
I will submit two abstracts


Room preference

Please, write here your preference for double or triple room and/or for roommate(s)
(The rooms will be assigned following the order registration)


Dietary requirements

Please, write here your dietary requirements:


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