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: Italy+0461 810629
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