Registration Form

Registration fee includes:
Attendance to the Scientific Sessions
Conference facilities
Proceedings (hard copy)
  Welcome cocktail; coffee breaks; 3 lunches; 1 gala dinner

Date
Surname
First name
Academic Title
Organization
VAT number (for invoicing)
Street or POBox
Town incl.Zip
Country
telephone
fax
e-mail

Fees ( 20% taxes included) Price Total
FULL FEE - payment* before May 15, 2006 600 EUR
STUDENT FEE - payment* before May 15, 2006 360 EUR

In addition to the items included in my fee I would like to buy:
extra ticket lunch
(for accompanying persons)		 30 EUR
extra ticket gala dinner
(for accompanying persons)		 100 EUR
Total paid

* The submission of this form becomes a valid registration only after the payment has been received.
* After May 15, 2006 all the fees will be Euro 660.

I am settling my payments by the following way (tick as appropriate):

Cheque made payable to "AIDIC Servizi S.r.l." (please send to address of MIXING2006 Secretariat)

Bank transfer to:
AIDIC Servizi S.r.l.
(bank name and agency number) BANCA INTESA, Ag. 59,
(address) Via CELORIA 2, I-20133 Milano, Italy
(bank coordinates) CIN M ABI 3069 CAB 01749 ACCOUNT 000011154138
SWIFT CODE: BCI T I T 33124 - IBAN CODE: IT72M0306901749000011154138
Please make sure that your bank transfer charges are not deducted from the total payment required. Please indicate in the transfer form the name of the participant and the company.
Credit Card
Type of Credit Card

Credit Card No
(16 digits)
Card expiration date
Card holder

Cancellations before June 10, 2006 will be charged by 20% costs. We regret to inform that cancellations after June 10 will not be refunded. Only written cancellation will be accepted (letter or fax, not e-mail). Substitutions will be accepted at any time, provided they are notified.