s MI&T Congressi - Organizzazione Congressi - Iscrizione al Congresso

 

REGISTRATION FORM:
   Crystal Forms June 9-10-11, 2019
   
    Period : 9th June 2019 - 11th June 2019
    Location : Aemilia Hotel
   On-line Registration will be available until 2nd June 2019
 
   Family Name *
   
 
   Name *
   
 
   Place of Birth *
   
 
   Date of Birth *
   
 
   Heading name in case of company's invoice
   
 
   VAT number (for companies) and SDI (for Italian companies only)
   
 
   Profession/Specialization *
   
 
   Institute
   
 
   Professional address
   
 
   Personal address *
   
 
   City *
   
 
   Postal Code *
   
 
   Nation *
   
 
   Phone *
   
 
   Mobile
   
 
   Fax
   
 
   Intolerances/food allergies
   
 
   E-mail *
   
 
    Privacy
   
    I have read and I accept the above conditions
 
Select Option
After 30/04/2019
Students
€ 250,00
Academics
€ 500,00
Companies
€ 1.000,00
Speakers (free registration)
€ 0,00
 
 
Payment Mode

Bank Transfer:
Owner : MI&T SRL
IT71I0638502403100000004376
Swift Code/Bic Code IBSPIT2BXXX
Description:

Credit Card (CartaSi, Visa, Visa Electron, Mastercard, American Express)
 
Amout to pay: