Family Name (required)

Name (required)

Mrs./Mr. (required)

 Mrs. Mr.

Country (required)

Full Name of the person you are accompanying(required)

Email (required)

Which type of conference fee for accompanying persons did you choose? (required)
 Reduced fee (80 euros - covers visit of the square of miracles and social dinner) Full fee (180 euros - covers visit of the square of miracles, social dinner and lunches and coffee breaks)

Payment Type (required)

 Credit Card PayPal Bank Transfer

If you performed a bank transfer, please provide its number

Data for Receipt (Including receipt header, institution, address and fiscal code)

Are you attending the social dinner? (required)

 Yes No

Do you need a particular diet? (required)

 Yes No

If you answered yes to the previous question, which kind of particular diet do you need

I hereby authorise the congress organisers to handle and process my personal data under the Italian Legislative Decree n.196 of 30/06/2003.
Do you accept?

Type the code shown below:


captcha