Please type or write in CAPITAL LETTERS and send by e-mail (gianpaolo.carlino@na.infn.it) before 30 April 2001
PARTICIPANTS
Surname _________________________
First name _____________________________
Institution: ____________________________________________________________________________
Mailing Address ( ) Residence
( ) Institution
____________________________________________________________________________________
City _______________________________ State/Prov __________________
Code_________________
Country ___________________________ Telephone __________________ Fax ___________________
E-mail: ______________________________________
ACCOMPANING PERSONS
Surname _________________________
First Name ______________________________
Surname _________________________
First Name ______________________________
REGISTRATION FEES
200.000 Italian Lire both for participant and accompaning persons, to be payed at Workshop Desk
Date _______________ Signature _________________________