13-15 September - Centro 3R: IV ANNUAL MEETING - Author Registration

PERSONAL DATA

NAME* SURNAME* E-MAIL* INSTITUTION/UNIVERSITY* FISCAL CODE (MANDATORY FOR ITALIAN CITIZENS) DATE OF BIRTH* PLACE OF BIRTH (TOWN, COUNTRY)* PERSONAL ADDRESS (STREET, TOWN, STATE/PROVINCE...)* ZIP CODE COUNTRY* TYPE OF INVOICE* INVOICE TO PERSON INVOICE TO COMPANY

COMPANY DATA

THIS SECTION IS MANDATORY IF YOU CHOSE INVOICE TO COMPANY

COMPANY/ BUSINESS NAME VAT NUMBER COMPANY FISCAL CODE CODICE SDI PER FATTURA ELETTRONICA (ONLY FOR ITALIAN COMPANIES/INSTITUTIONS) COMPANY ADDRESS (STREET, TOWN, ZIP CODE, STATE/PROVINCE...) COMPANY COUNTRY

ADDITIONAL INFORMATION

DO YOU HAVE ANY DIETARY REQUIREMENTS?* IF YES, PLEASE SPECIFY YOUR DIETARY REQUIREMENTS ARE YOU SUBMITTING A PAPER?* WHICH DAY/DAYS ARE YOU ATTENDING?*

FEES

REGISTRATION FEE* For STUDENTS: please upload here a proof of your student status (Max 5 MB) CHOOSE YOUR PAYMENT METHOD*

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Acconsento al Trattamento dei dati* - I authorise the privacy policy*

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