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 CardPayPalBank 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)

    YesNo

    Do you need a particular diet? (required)

    YesNo

    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.

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