INA 9

Registration Form

To Be Paid by Wire Transfer to:

Account Number 989/9, Banca Monte Parma Ag. 10, ABI 6930, CAB 12720,
Swift Code BMPRIT2P

Please fill in this form:

NOTE that the on-line registration will be valid only once we will have notice of your succesfull wire transfer to our bank


Personal Data  
*Your full name:

*Your email address:

*Prof. / Dr. / Mr. / Ms. / Mrs. / Miss.:

*Birth Date:

*Organization:

*Country:

*Phone:

 

*Mailing address:

*Fax:

*Alternative E-Mails:

* these fields must be filled

Presentation: ORAL
POSTER
NONE

Title(s) of abstract(s):


REGISTRATION FEE  
N° of Persons
Partecipant

110 EUR

Student
70 EUR

Post-conference field-trip

150 EUR

Conference Dinner

32 EUR

Delayed Registration Fee

140/80 EUR


Total:




To Be Paid by Wire Transfer to:

Account Number 989/9, Banca Monte Parma Ag. 10, ABI 6930, CAB 12720,
Swift Code BMPRIT2P



An acknowledgment of the received form will be sent to you within a day.

© 2000 G. Villa - Earth Sciences Dpt. - University of Parma - Italy