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SUBSCRIPTION FORM - PhD SUMMER SCHOOL AIAS, ADVANCED METHODS FOR MATERIAL TESTING

PERSONAL INFORMATIONS

LAST NAME

FIRST NAME

DATE AND PLACE OF BIRTH

FISCAL CODE (only for italian people)

VAT NUMBER Obbligatoria per i liberi professionisti per l'intestazione della fattura

ADDRESS OF RESIDENCE

TELEPHONE No.

MOBILE No.

E-MAIL

INVOICE DATA

DO YOU WANT TO INVOICE YOUR COMPANY OR ORGANIZATION?

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 Please choose the fee of interest

€ 330,00 + IVA 22%= € 402,60

€ 330,00 IVA ES. (only for italian people)

METHOD OF PAYMENT

BONIFICO BANCARIO/BANK TRANSFER 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

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

CARTA DI CREDITO/CREDIT CARD

ACCOMODATION

Are you interested in a hotel agreement accomodation co-financed by AIAS? no. 3 nights, from 22 to 25 june

If yes, could you be disposed to share a double room?

If yes, you may indicate here a name of a person

MESSAGES FOR THE SECRETARIAT

NOTES

PRIVACY POLICY - Informational statement according to article 13 of Legislative Decree 196/2003 (Code on protection of personal data) Information and personal data are collected through the voluntary compilation of the form and are used for the purpose of the participation to the Workshop. The data collected can be memorized both in electronic and paper format and will be used by us respecting all the measures provided by law for the safeguarding of the rights of the interested parties.The giving of data is optional; possible refusal to provide this data could mean the inability on our part to send the information requested and process your registation to the workshop. Data will be used also with electronic devices and may be used for administrative, fiscal and/or commercial activity. We will not pas data to unauthorized third parties. Responsibility for the use of data is Consorzio Futuro in Ricerca, Via Saragat 1, 44122 Ferrara (FE). You should act for your right as stated in art. 7, by sending an e-mail to cfr@unife.it.

I have read and agree with the above statement

YES

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