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AICS2012_Registration_Form
Structure, Microstructure & Nanostructure | 15-20 September 2012 Sardagna (Trento - Italy)
Registration Deadline: 1st June 2012
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Academic Young
Academic Young (AIC Member)
Academic Senior
Academic Senior (AIC Member)
Non Academic
Non Academic (AIC Member)
Accompanying Person
Title [Select]
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Dr.
Mr.
Mrs.
Miss
Apply for a Grant [Select]
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No
Yes
Surname
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Your answer
Name
*
Your answer
Gender [Select]
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M
F
Affiliation
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Your answer
Address
*
Insert your Affiliation Address
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e-mail address
*
Your answer
Accomodation Booking [Select]
*
This reservation is valid only for official school registration formula. If you choose 'No Accommodation' formula, you can book an hotel visiting
http://www.apt.trento.it/en/Accomodation/Accomodation.htm
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Single Room Registration
Double Room Registration
No Accommodation
Sharing double room with?
If yes, please insert Surname and Name
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Arrival Date
*
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Departure Date
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Do you are also registered to XLI AIC National Congress (Verona, September 11-14 2012)?
*
the answer is for information only. For congress registration, please visit
http://maci.scienze.univr.it/aic2012/
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Yes
No
Social Dinner partecipation?
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Yes
No
Special Food Request?
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Yes
No
Comments
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Amount school (EXCLUDING extra nights)
In order to apply for a grant, please send, no later than May 20th 2012, your C.V. and a presentation letter signed by your tutor supporting and justifying the request to
info@aicschool.org
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