REGISTRATION FORM
4th ECNP YOUNG RESEARCHERS CONFERENCE
ENCP TRAINING WORKSHOP
ECNP INDUSTRIAL MEETING
Lyon (France) – Villa Villemanzy, November 7-10, 2011

* required fields

DEADLINE for payment of registration fee: September 30th, 2011

* Surname:
* First Name:
* Title:
* Institution:
* Mailing Address:
 
 
 
* City:
* ZIP Code:
* Country:
* Tel. Number:
FAX number:
* E-mail address:
*Registration Fee
 
Participant to “4th ECNP Young Researcher Conference” “ECNP Workshop on Interfaces in Nanocomposites”
€ 250,00 (incl. 20% Italian VAT)
Registration AFTER September 30th, 2011  
Participant “4th ECNP Young Researcher Conference” “ECNP Workshop on Interfaces in Nanocomposites” “ECNP Industrial Meeting”
€ 300,00 (incl. 20% Italian VAT)

*Billing Address
Please read carefully before proceeding.
The field "VAT no. / Fiscal Code" has mandatorily to be filled out, even in case the billing address is the same than the participant's address.
The Billing Address is the address the relevant invoice should be ISSUED to. Please note, that in case of credit card payment the invoice obligatorily has to be issued to the cardholder. Example: You CANNOT use your personal credit card, if you want the invoice to be issued to your institution (or vice versa). Kindly keep in consideration this important point while compiling the following fields.

*Billing Address
 Same as above New
* VAT No (Billing to institutions) OR
Fiscal Code (Billing to physical persons)

* Payment

Bank transfer with reference to “4th ECNP Young Researcher Conference” and“ECNP Workshop on Interfaces in Nanocomposites", specifying the name of the participant, made payable to:

ECNP S.c.a.r.l. (Via G. Giusti, 9 - I-50121 Florence - Italy - VAT no. IT 05660910489)
Account no. 5701/88
IBAN: IT 48 G 01030 02827 000000570188
BIC: PASCITM1W40
Banca Monte dei Paschi di Siena - Agency no. 01874
Via del Corso, 6 - I-50122 Florence, Italy

Please send the amount due free of any bank charges.

Credit card (VISA, Mastercard).

For payment by Credit Card, please download and print the proper form (Authorisation for Credit Card Payment), fill it out clearly with all required information and then send it ONLY by FAX to:

Ms. Debora Puglia
ECNP S.c.a.r.l.
Fax no. +39-0744-492950

IMPORTANT: The above mentioned form DOES NOT substitute the present Registration Form. Sending ONLY the form for the credit card payment DOES NOT complete your registration.

ATTENTION! Your registration will be valid only with your acceptance of the conditions reported below:
With reference to the Italian law 196/03 we wish to inform you that your personal data will be used within the “4th ECNP Young Researcher Conference” and “ECNP Workshop on Interfaces in Nanocomposites" institutional activity. We also wish to inform you that your personal data will be inserted in the participant list relevant to the present event.

I herewith confirm that I agree that my submitted data concerning addresses, booking and methods of payment be electronically stored and processed in order to organize and manage this event. Furthermore, I accept that address and personal data are used for purposes connected to the event's management and will be published in the list of participants.