Please
send the form, preferably by e-mail, to
Augusto Micheletti, Secretary of
CIRM
Fondazione Bruno Kessler
Via Sommarive, 14 – Povo
I- 38123
fax:
michelet@science.unitn.it
REGISTRATION FORM
Summer School on Transport,
Fluids and Mixing
Levico
Terme (Trento), July 19-24, 2015
Family Name:
First Name:
Citizenship:
Full address:
e-mail:
Present professional position:
I need a single/double bedroom
I would like to present a poster:
Yes/No
Title of the poster:
Arrival date (standard: Sunday, July
19th afternoon):
Departure date (standard: Friday,
July 24th lunch time):
Date:
Signature