FAMILY NAME

GIVEN NAME

E-MAIL

INSTITUTION

ADDRESS

ACCOMMODATION
We will arrange the rooms reservation with the hotel, therefore we need to know your arrival and departure dates. Notice that you will have to pay directly to the hotel on departure.
ARRIVAL

DEPARTURE

DOUBLE/SINGLE USE

FOR DOUBLE USE, NAME OF THE PERSON SHARING THE ROOM


COMMENTS



REGISTRATION FEES
I have sent a copy of a bank transfer order for a total of
by fax 34 968 325 694

( If you have any problem, fill and print the registration form and send it by fax together with a copy of the bank transfer)