REGISTRATION REQUEST FORM

*Required information

PERSONAL INFORMATION

FIRST (& MIDDLE) NAME*

FAMILY NAME*

GENDER*
MF*

DATE OF BIRTH* (1)

E-MAIL*

Please check again your e-mail address.

WEB

TEL. (home)*

TEL. (work)

FAX

OCCUPATION

INSTITUTION or JOURNAL

Students should indicate University and course of study.

CATEGORIES*

MAILING ADDRESS

ORGANIZATION

Fill in only if you choose your office as mailing address.

STREET*

ZIP*

TOWN*

COUNTY or STATE*

COUNTRY*

FURTHER INFO

This is just a registration request. If your request is accepted, you will receive an e-mail with instructions to access the 2022 Giornate on-line registration form.

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