| APPLICATION - REGISTRATION
FORM |
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Compile the form and
submit. |
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| Participant |
| Last name: |
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| Middle initials: |
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| First name: |
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| Affiliation: |
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| Address: |
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| Zip code: |
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| City: |
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| Country: |
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| E-mail: |
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| Telephone: |
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| Fax: |
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| Accompanying
person (not participating the symposium) |
| Last name: |
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| Middle initials: |
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| First name: |
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| Registration
fee (in euros) |
Before
April 1, 2003 |
After
April 1, 2003 |
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Regular participant1 |
€ 450 |
€ 500 |
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Student2 |
€ 300 |
€ 320 |
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Accompanying person3 |
€ 150 |
€ 170 |
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| 1. |
Registration fee includes:
registration packet, proceedings, lunches, coffee breaks,
a reception, a banquet, a half-day tour. |
| 2. |
Registration fee includes:
registration packet, lunches, coffee breaks, a reception.
An official University letter confirming Student Status
must be sent (fax or mail) to the Symposium Secretariat. |
| 3. |
Registration fee includes:
a reception, a banquet, a half-day tour. |
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| A further cultural event
included in all fees is being organized. |
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Other social events payable on site will
be organized next for accompanying persons, provided
a minimum number of participants will attend.
Check if you are interested. |
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Interested in social
events |
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| Special
diet requirements |
| If you have special diet requirements
please let us know. |
| Required diet: |
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| Way
of payment |
Payment must be in the form of
a Bank Transfer in euros.
Please state clearly your name on the bank transfer. We have
to insist that you cover all costs of this bank transfer.
Registration will become final when fee has been received. |
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| Bank transfer in euros to: |
| Account name: |
C.A.D.I.S |
| Account address: |
c/o Dipartimento di Ingegneria Strutturale
e Geotecnica
Via Eudossiana 18, 00184 Rome, Italy |
| Bank name: |
UniCredit Banca S.p.A. |
| Bank address: |
Piazza Mazzini 13, 00195 Rome, Italy
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| Swiftcode: |
IT EUR 62 W 2008 3219 |
| Account N°: |
3973635 |
| IBAN: |
IT62W0200803219000003973635 |
| Mentioning: |
'IUTAM Symposium' and your name |
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| Please fax a copy of the official
order number of the bank transfer to: |
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Dr. Roberta Marzellotta |
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Dipartimento di Ingegneria Strutturale
e Geotecnica |
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Via Eudossiana 18, 00184 Rome, Italy |
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Fax: +39-06-4814548 |
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| Please provide the address to which
the receipt has to make out. The receipt will be available
at the Symposium. |
| Receipt address: |
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| Cancellation |
| Cancellation received before May
15, 2003 will permit a refund with a deduction of 30% costs.
If cancellation is received after May 15, 2003 the full conference
fee will be charged. (Balance will be refunded after the Conference). |
| All cancellations or changes must
be received by the Secretariat in writing or fax. |
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Submit after checking
your data. |
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Reset the registration
form. |
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