Please send the form, preferably by e-mail, to

Augusto Micheletti, Secretary of CIRM
Fondazione Bruno Kessler

Via Sommarive, 14 - Povo
I- 38123 Trento, Italy
fax: +39-0461-810629
micheletti@fbk.eu

REGISTRATION FORM

Conference on “Sub-Riemannian Geometry and PDEs”

Levico Terme (Trento), July 2-5, 2012

 

Last Name:     

First Name:                        

Citizenship:         

Full address:        

                            

e-mail:                  

Present professional position:           

Date of arrival (standard: Sunday, July 1 afternoon/evening):           

Date of departure (standard: Thursday, July 5 after lunch): 

[  ] single bedroom

[  ] double bedroom. I would like to share the room with ……………………….