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

Groups of Automorphisms in Birational and Affine Geometry

Levico Terme (Trento), October 29-November 3, 2012

 

Family Name:     

First Name:                        

Citizenship:         

Full address:        

                            

e-mail:                  

Present professional position:           

Arrival date (standard: Sunday, October 28th afternoon/evening):           

Departure date (standard: Saturday, November 3rd after lunch): 

 

 

Date:                                                                

Signature                         

                               

>