REGISTRATION FORM - PhD SUMMER SCHOOL AIAS, NON-LINEAR BEHAVIOR OF MATERIAL THEORY AND APPLICATIONS

PERSONAL INFORMATIONS

GENDER/GENERALITA'   MALE/MASCHIOFEMALE/FEMMINA

LAST NAME/COGNOME  

FIRST NAME/NOME  

DATE OF BIRTH/DATA DI NASCITA   (dd/mm/yy)/(gg/mm/aa)

PLACE OF BIRTH/LUOGO DI NASCITA  

CODICE FISCALE (only for italian people)

PARTITA IVA (only for Italian people) Obbligatoria per i liberi professionisti per l'intestazione della fattura

ADDRESS OF RESIDENCE/INDIRIZZO DI RESIDENZA  

CITY/CITTA'  

ZIP CODE/C.A.P.  

COUNTRY/STATO  

MOBILE No.  

E-MAIL  

INVOICE DATA

DO YOU WANT TO INVOICE YOUR COMPANY OR ORGANIZATION?   -------------------------------------------------------------NO (THE INVOICE WILL BE ADDRESSED DIRECTLY TO THE PARTICIPANT)YES (FULL DATA ARE STRICTLY REQUIRED)

FULL NAME OF THE COMPANY OR ORGANIZATION

COMPANY OR ORGANIZATION COMPLETE ADDRESS Address, zip code, city and state

COMPANY/ORGANIZATION FISCAL CODE OR VAT NUMBER (MANDATORY) IN ABSENCE OF THESE DATA THE INVOICE WILL BE ADDRESSED DIRECTLY TO THE REGISTRANT.

REGISTRATION FEE

FEE  

€ 350,00 + IVA 22%= € 427,00

METHOD OF PAYMENT

BANK TRANSFER/BONIFICO BANCARIO Account Name: Consorzio Futuro in Ricerca Bank Details: Unicredit Banca Account Number: 1326114 CIN: W - ABI: 02008 - CAB: 13009 IBAN: IT 87 W 02008 13009 000001326114 SWIFT/BIC: UNCRITM1Y73

ENCLOSE BANK TRANSFER RECEIPT/ALLEGA COPIA DELLA RICEVUTA DI PAGAMENTO REQUIRED FOR PAYMENTS BY BANK TRANSFER/ OBBLIGATORIO PER I PAGAMENTI EFFETTUATI TRAMITE BONIFICO BANCARIO

CREDIT CARD/CARTA DI CREDITO

ACCOMODATION

ARE YOU INTERESTED IN A HOTEL AGREEMENT ACCOMODATION CO-FINANCED BY AIAS?   no. 3 nights, from 13 to 16 june YESNO

IF YES, COULD YOU BE DISPOSED TO SHARE A DOUBLE ROOM? YESNO

IF YES, YOU MAY INDICATE HERE A NAME OF A PERSON:

MESSAGES FOR THE SECRETARIAT

NOTES