Registration Form

Send this form to roberto.monaco@polito.it



SURNAME: ___________________________ NAME:___________________________

INSTITUTION or/and UNIVERSITY: ________________________________________

POSITION: _____________________________________________________________

ADDRESS: _____________________________________________________________

ZIP CODE: ________ CITY:______________________COUNTRY: _______________

PHONE NR: _________________________ FAX NR: __________________________

E-MAIL: _______________________________________________________________

A poster session for young participants is planned on Friday 8th, afternoon.

DO YOU WANT TO PRESENT A POSTER?             YES          NO

IF YES PLEASE WRITE A TENTATIVE TITLE _____________________________________

_________________________________________________________________________________

SINGLE ROOM        YES        NO

DOUBLE ROOM       YES        NO      (To be shared with ___________________________)

NUMBER OF ACCOMPANYING PERSONS: _________

DATE OF ARRIVAL: ________________DATE OF DEPARTURE: ________________
(Please, note that participants are supposed to arrive not later than Sunday June 3rd and to leave not before the end of the morning of Saturday June 9th).