13th INTERNATIONAL MULTIPHASE FLOW IN INDUSTRIAL PLANTS
17-19 September 2014 - Sestri Levante (GE) – Italy
To send by fax or email to the Secretary ANIMP SERVIZI Srl – Via Enrico Tazzoli, 6 – 20154 Milano - Italy
Phone 0039.02.67100740 – Fax 0039.02.67071785 E-mail: [email protected]
(please fill it in block letters)
SURNAME……………………………………….……………………… NAME……………….……………………………………………….
COMPANY or UNIVERSITY……………………………………………………….……………………………………………………………
ADDRESS….……………………………………………………………………………….………………………………………………………….
POSTAL/ZIP CODE……….……… CITY……………..………..……………….. COUNTRY…………….….…………………………
PHONE………………….…………………….…………….. E-MAIL………….……………………………………………………………….
VAT CODE or FISCAL CODE………………………………………………………………………………………………………………..
REGISTRATION
Last date for early bird registration: August 12th, 2014
Deadline registration:
September 10th, 2014
DECLARE TO HAVE PAID THE SUBSCRIPTION OF:
After August 12th, 2014
Early Bird Registration
□ Person submitting Paper-Poster/ Full
Time Subscription
€ 450,00 (+22% VAT UE&Extra UE)
Total = € 549,00
€ 550, 00 (+22% VAT UE&Extra UE)
Total = € 671,00
□ Full Time Students
€ 250,00 (+22% VAT UE&Extra UE)
€ 300,00 00 (+22% VAT UE&Extra UE)
(Requested to fax +390267071785 a proof
of their status: student card or similar)
□ Accompanying Person Program and
Social Dinner
Total = € 305,00
Total = € 366,00
€ 100,00 (+22% VAT UE&Extra UE)
Total = € 122,00
€ 150,00 (+22% VAT UE&Extra UE)
Total = € 183,00
r By bank transfer on (date)…………………………
OR r By Credit Card
Total amount € …………………………………
To: Animp Servizi Srl c/c 100408125 della Unicredit
ABI 02008 – CAB 01758 – Cod. CIN “Q” - IBAN IT87Q0200801758000100408125
Swiftcode: UNCRITM1M67
In accordance with the Legislative Decree 196/2003, the return of this form is to be considered as explicit permission to use the
information contained herein for purposes related to the initiative itself and the inclusion in the list of participants that will be
distributed exclusively in the context of the Conference .
PLACE & DATE
SIGNATURE
…………………………………
…………………..………………………
Conditions of Payment
1-Use this format for the registration only
2-Registration fee must be paid by bank transfer or by credit card
3-All payments must be done in Euro
4-All banking charges must be paid by the payer
5-Registration accepted only 100% payment
6-Checks are not accepted
7-Title of bank transfer must include participant’s name
8-Only after receiving the payment, ANIMP SERVIZI SRL will issue
and send the invoice to the payer.
Conditions of change & cancellation
1- In case of cancellation before September 5th, 2014 paid amount will
be returned minus 50%.
Money shall be returned no later than 4 weeks after the end of the
Congress.
2- No refund will be made for cancellation after September 5th, 2014.
3- All notifications of cancellation must be in writing.
4- Name changes will be allowed free of charge until September 5th,
2014.