REGISTRATION  FORM

 
 
 Title: Prof Dr Mr   Mrs Mss
 Last Name
 First Name
 Institution
 Department
 Address
 
 ZIP Code  City
 Country  E-mail
 Phone  Fax
 
 Are you submitting an abstract?  Yes   No
 

 REGISTRATION FEE:

  • Fee includes access to scientific sessions, conference material, coffee breaks and welcome cocktail
 

 Available until April 12, 2003
 
 ECA member € 250,00

 Technologists

 (ECA member)

 € 150,00
 Non-ECA member € 300,00

 After April 12, 2003
 
 ECA member € 300,00

 Technologists

 (ECA member)

 € 200,00
 Non-ECA member € 350,00
 

 Accompanying person(s):

 does not include attendance to the scientific sessions
 Last Name
 First Name
 Last Name
 First Name
 
€ 80,00 x  person(s) =  €
 
   
SOCIAL PROGRAM:

due to limited space, the reservation will be made on the first arrived first served basis (please ticck the appropriate choice and mention the number of person(s) that will attend
 
WELCOME COCKTAIL  Saturday, Sept. 6    person(s)
CONFERENCE DINNER  Monday, Sept. 8

 € 90,00 x

 person(s)
     

=€

 

TOTAL DUE: €
 
PAYMENT DETAILS:
sorry, but no registration and reservation will be accepted without the corresponding payment. Payment must be made without charges to the beneficiary, neither cheques nor Eurocheques are accepted. Bank transfer reference MUST include delegate name(s).
 
Bank transfer
Bank detail: UNICREDIT BANCA - Corso Italia 259 - 80067 Sorrento (NA), IT
Account number: 3807157 - CIN EUR 06 - CIN E - ABI 02008 - CAB 40260
Reference: Delegate Name FECC 2003 CONFERENCE REGISTRATION FEE
 

Date:

 
Authorization to process data:

I authorize elaboration and electronic processing of my personal data

(Italian law n. 675/96)

Yes

No
   
 

 

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