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Registration Form for the MKM 2003 Conference
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The fields marked with a star (*) are mandatory.

First Name (*):

Last Name (*):

Institution (*):

Address (*): 

Email (*):

Homepage:

Telephone (*):

Fax (*):

Arrival date (*):

Departure date (*):

Expected landing/departure time to/from Bologna Airport BLQ:
(this information is not mandatory, however we may try
to organize a bus service from Bologna to Bertinoro. Please
consult regularly the conference home page for up-to-date
information)

Room (single/double) (*): 

Room Mate:
 
Excursion to Ravenna on Monday afternoon (yes/no) (*):

Participation to social dinner on Monday evening (yes/no) (*):

Vegetarian (yes/no):