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
augusto.micheletti@unitn.it

REGISTRATION FORM

CR-Geometry and PDE’s – VII

Dedicated to the memory of Giuseppe Zampieri

Levico Terme (Trento), June 27-July 1, 2016

Family Name:

First Name:

Citizenship:

Full address:

e-mail:

Present professional position:

Arrival date (standard: Sunday, June 26 afternoon):

Departure date (standard: Friday, July 1 lunch time):

Date:

Signature