Registration Form
(to be returned as soon as possible, but not later than 8 April 2005)
Albergo delle Terme, Castel San Pietro Terme
(Bologna), Italy
6-10 June, 2005
1. Name -
Last: First:
2.
Institution:
3.
Professional Level:
4. Mailing address:
5.
Email:
6. Fax
(please include country code):
7.
Telephone (please include country code):
8. Please
indicate your level of interest
I will attend:
May attend, but not sure:
9.
Accommodation preferences:
Are
you willing to share a room?
10.
Financial Support. We expect to have limited financial support for this
meeting.
Will you like financial support, if
available?
If so, do you need support for: (please select
only those that apply)
Plane fare? Train
ticket ?
Accomodation?
11. Do you
have any special dietary requirements? [Vegetarian, Diabetic, Vegan, etc.]
12. By air?
If yes, your expected
arrival date and time at BLQ airport
is ________
departure date and time from BLQ
airport _____
13. Mode of transportation to Castel San
Pietro.
Will have own car? Y/N
Will
take a bus line? Y/N
Please
return the completed form by email to b.neri@ira.cnr.it
, or alternatively
by FAX to
+39-051-639-9431
Last modified: May 16, 2005