| PARTICIPANT
INFORMATION |
Please pay attention in filling correctly name and surname (it has to be the same used into the paper) |
Title |
|
| First name |
|
Family name (surname; last name) |
|
| e-mail |
|
please
note that all correspondence and invoicing
will be by e-mail. Use always the same (and only one) address; possibly, check that your spam system accepts our correspondence |
| INVOICING
INFORMATION |
| Organization |
|
Department |
|
| Postal Address |
|
Town incl. Zip |
|
| Country |
|
Fax |
|
|
VAT number
(for invoicing to organization)
Personal fiscal code
C.F. (for invoicing to private person) |
|
According
to Italian fiscal rules, this registration form can be accepted only
if either VAT number of the Organization (for invoicing to organization)
or C.F. of the participant (for invoicing to a private person) is
provided.
In most cases, each Organization it is supposed to have an id number for fiscal purposes, so please check with your Administration.
|
| REGISTRATION
FEE |
|
|
EARLY FEE
paid until
June 23rd |
REGULAR FEE
paid from
June24th |
| |
NOTE: AUTHORS HAVE TO BE REGISTERD BEFORE MAY 23rd |
| Full delegate (dinner is included) |
|
| Student & PhD student (dinner is NOT included) |
|
| extra dinner ticket (for student & accompanying person) |
|
| ACCOMPANYING
PERSON |
|
| PAYMENT
TO AIDIC SERVIZI (tick as appropriate) |
|
CREDIT CARD (only VISA and MASTERCARD are accepted)
Please make sure that your card has not any
additional security password or any kind of restriction
|
|
BANK
TRANSFER to
(beneficiary) AIDIC Servizi S.r.l.
IBAN CODE: IT72M0306901749000011154138
(bank name and agency number) BANCA INTESA, Ag. 59
(address) Via CELORIA 2, I-20133
Milano, Italy
SWIFT CODE: BCI T I T 33124
Please make sure that your bank transfer charges
are not deducted from the total payment required.
Please indicate the participant's LAST NAME on the bank transfer form
to avoid mistakes in the attribution of the credit |
| IMPORTANT
NOTES |
- A registration is valid and confirmed only when the
payment of the registration fee is received.
- The deadline for early registration at a reduced
fee refers to the payment date and not to the online registration
submission date.
- Cancellations before July 30th, 2013 will be charged
by 20% costs. Beyond such date the registration fee will not be refunded.
Only written cancellations will be accepted (letter or fax to the
postal address of the PHM Secretariat, not e-mail).
- Conference proceedings will NOT be mailed, however a delegate can pick it up.Substitutions will be accepted at any time, provided
they are notified to the Secretariat in advance.
- We reserve the right to cancel or alter the program.
|
|
|
AIDIC Servizi Srl
Via Giuseppe Colombo 81/A 20133 Milano
P.IVA and Fiscal Code 11667680158 |
|