application_form


Application Form

GALILEO GALILEI FOUNDATION

WORLD FEDERATION OF SCIENTISTS

ETTORE MAJORANA FOUNDATION AND

CENTRE FOR SCIENTIFIC CULTURE

Erice- Sicily

INTERNATIONAL SCHOOL OF SOLID STATE PHYSICS

79th Course/School: EPIOPTICS 2020

25 – 31 July 2020

REGISTRATION FORM & HOTEL RESERVATION

First name Surname
Gender   M                          F
Institution Mailing address
Phone Fax e-mail address
Arrival date

Time

Airport and Flight
Departure date
Time
Airport and Flight
Please reserve a single room Please reserve a double room
Full name of the
accompanying person
Signature Date
Please return this form NOT LATER than
June 1st 2018
by fax or e-mail: school@ism.cnr.it
Dr. Antonio Cricenti
CONSIGLIO NAZIONALE DELLE RICERCHE
AREA DI RICERCA DI ROMA TOR-VERGATA ISTITUTO DI STRUTTURA DELLA MATERIA
Via del Fosso del Cavaliere, 100 – 00133 Roma – Italia
Tel: +39 0645488476 – Fax: +39 0649934153