WARNING: Eventual co-authors of poster/talk can be indicated in the ABSTRACT as "Joint work with ... and ..."

INSERT the FOLLOWING DATA:

LAST NAME:

FIRST NAME:

PLACE OF BIRTH: DATE OF BIRTH:

AFFILIATION:

E-MAIL ADDRESS:

DATE OF ARRIVAL: DATE OF DEPARTURE:

SINGLE ROOM: (YES/NO)

DOUBLE ROOM: (YES/NO) (*)

DO YOU INTEND TO PRESENT A TALK (20 MIN): (YES/NO)

IF YES, GIVE THE TITLE (max. 100 characters) and THE ABSTRACT (max. 1000 characters):

TITLE:

ABSTRACT:

DO YOU INTEND TO PRESENT A POSTER: (YES/NO)

IF YES, GIVE THE TITLE (max. 100 characters) and THE ABSTRACT (max. 1000 characters):

TITLE:

ABSTRACT:

(*) If you choose a double room, please indicate the person with whom you share the room. If you come with an accompanying person, please indicate the name followed by "ACCOMPANYING" (the hotel fee is the same as for partecipants).

Example: DOUBLE ROOM: (YES/NO) Yes (*) John Green (ACCOMPANYING)