*******PARTICIPANT DATA
Name:
Surname:
date of birth:
place of birth:
Institution:
e-mail:
Submitted poster?:
Submitted talk?:
Student?:

************* DATA FOR THE INVOICE
Who is paying? if it is 
not the participant above please specify the name
of the Institution:  

Address to use for invoice (complete of ZIP code and number):

(if Italian and paying person) codice fiscale:
(if Italian and paying Institution) Partita IVA:
(if not Italian and paying Institution) Vat account of institution:

Nationality of person or institution paying:

Fee Paid (indicate the amount):