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Please fill in this form following the indications of the Meeting you are registering to

Title of the Meeting *

Venue

Date *

dd/mm/yyyy

Personal data

Name *

Surname *

Born on

dd/mm/yyyy

Street *

Number *

Town *

Zip Code *

Telephone *

Fax

E-mail *

Country *

Fee and Invoice:

If iscription is free, do not choose any method of payment.

Free**

Payment of registration fee €*

Select which item is included

By means of:

Check**

check number*	Sent on*

Bank transfer**

bank transfer number*	Sent on*	Sent through bank*

Credit Card**

Heading of invoice

Street

Town

VAT number

Country

Notes

I authorize the treatment of my personal data to the sense of law 675 on the privacy. The data will not be shared to other subject different from those who cooperate in providing services

The (*) fields are compulsory.
At least one of the (**) fields are compulsory.

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