AC 2005: University of Bologna First Summer School on Aspects of Complexity 18-28 July 2005 University of Bologna Residential Center Bertinoro (Forlì), Italy

Registration Form

Please complete the form by filling out all the fields, click the "Submit" button below and follow the instructions that will appear on the next screen.

If there is any information you need to convey that is not covered by this form, please send it by email to Guido Fioretti.

First Name:
Last Name:
Sex:    Male    Female
Institution:
Department:
Street Address:
City:
Province/State:
Zip Code:
Country:
E-mail Address:
Make sure you entered a valid email address. To confirm your registration, you will be asked to reply to a message sent to your address.

I am an undergraduate, a MPhil/MSc/PhD or a post-doc. My registration fee is € 500.00
I am an assistant, an associate or a full university professor. My registration fee is € 800.00
I am a professional working for a non-academic institution. My registration fee is € 1,500.00

The registration fee includes full-board accommodation (lodging, breakfast, lunch, dinner) in a single room from the evening of July 17th, 2005 to the morning of July 29th, 2005.

Registration fees will be refunded net of a € 100.00 processing fee if cancellations are made before July 1st. No refund will be made on cancellations made after June 30th.

Payment is expected within one week upon notification of acceptance. One the two following means may be used:

Credit Card (Visa or MasterCard only). Please save the credit card authorization form on your local disk, complete it electronically, print it, sign it and fax it to +39 0543 446557

Bank transfer to
Banca Popolare dell'Emilia Romagna Filiale di Bertinoro Via Roma, 10 47032 Bertinoro (FC), Italy Recipient: Ce.U.B. (AC2005) IBAN: IT 19 N 05387 67721 00000 1052782 SWIFT (BIC): BPMOIT22 XXX

Please make sure that your name, address and "AC2005" appear on your bank transfer. Please send a copy of the transfer form to:
Ce.U.B. c/o Elena della Godenza (AC2005) Via Frangipane, 6 47032 Bertinoro (FC), Italy

Invoice of Payment:
The Italian law requires that an invoice be issued reflecting your payment. If you require the invoice to be issued to you personally, please make sure that you provide your name and home address (not that of your institution). The following fields are mandatory:

Invoice issued to:
Address of the above subject:
Tax/VAT number of the above subject:

Please hit the "Submit" button and follow the instructions on the next screen

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