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CIMTEC 2016

If on-line payment is not completed, the registration will not be filed.

Registration fees		Early (by April 20)	Late (after April 20)
Full Member *		-	€ 770.00
Student **		-	€ 490.00
Invited Lecturer (IL) and/or Member of Advisory Boards		-	€ 420.00
Companion ***	0	-	€ 290.00

Total amount to pay: €

Please note that an additional 3% bank commission is charged for on-line payment

* Authors of Contributed Lectures (L) and Posters (P), other participants
** Evidence of student status must be addressed to Congress Secretariat by e-mail or by post
*** Inscription to Companions Programme does not allow to attend technical sessions

Family Name

First Name

INVOICING DETAILS:

Institute/Company *

Department *

Full Address

Postal Code

City

Country

Phone

Fax

VAT Number

Tax Identification Number

(*) If you do not belong to any Institute / Company / Department, write NONE

I confirm attendance in the following complimentary socials
(please click YES or NO)

Welcome Party (June 6)	YES	NO
Jazz Concert (June 8)	YES	NO
Conference Dinner (June 9)	YES	NO

Are you a Presenting Author of a contribution already scheduled in the programme?	YES NO
Please indicate the Code Number of your presentation as assigned by the Conference Secretariat Code Number

If you want, you can submit here an abstract for "Hot" Poster presentation:

HOT POSTER SUBMISSION (deadline May 1, 2016)
Only Presenting Authors who do not have any oral or poster presentation already scheduled in the programme may propose a Hot Poster

Title of Poster

Authors and Affiliations

an asterix (*) should follow the name of the Presenting Author

to be included in Session

Abstract

(Maximum characters: 1300). You have characters left.

NAMES OF PARTICIPANTS TO COMPANIONS PROGRAMME
(please write the names of your Companions, if any. Separate by comma)
Inscription to Companions Programme does not allow to attend technical sessions

Names of Companions

Notes

I authorise the processing of my personal data

Cimtec 2016

Piva 03368230409

Phone +39 0546 22461 - Fax +39 0546 664138
Corso Mazzini 52 48018 - Faenza (RA) - Italy

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