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
michelet@science.unitn.it

REGISTRATION FORM

International Winter School on “Mathematical Fluid Dynamics”

Levico Terme (Trento), December 16-21, 2012

 

Family Name:     

First Name:                        

Citizenship:         

Full address:        

                            

e-mail:                   

Present professional position:           

Arrival date (standard: Sunday, December 16 afternoon/evening):           

Departure date (standard: Friday, December 21 after lunch): 

 

I would like to give a short communication: Yes/No

I would like to present a poster: Yes/No

Title:

Short abstract:

 

Date:                                                                

Signature