REGISTRATION FORM
IV° FORESIGHT TRAINING COURSE

Rome 1 - 3 September 2011


Name    *
Surname    *
Date Birth    *
Place Birth    *
Taxpayer number    *
Address    *
Post code    *
Town    *
Country    *
Tel    *
Fax   
email    *
      
Organization   
Job title   
Address of Organisation   
Post Code   
Town   
Country   
Tel   
Fax   
E-mail   
VAT number   
     
 REGISTRATION FEES (VAT excluded)  ( * Select one)
  Full
Course
Full Course
+ Dinners
Full Course + Dinners
 + Hotel (2 Nights)
Standard 
Graduate students 
       
 PRIVACY  ( * Select one)
In conformity with the Italian Legislative Decree n.196, art. 13 of 30 June 2003, the Gianni Benzi Foundation informs you that personal data will be handled for organisational purposes and for sending free of charge the documentation related to other congresses or initiatives organised by the Gianni Benzi Foundation only and will be by no means released to third parties. As provided by art. 7 of the Decree n.196, art. 13 of 30 June 2003, you can contact Gianni Benzi Foundation for further information (crossing out, correction, integration of data). If you agree, please give us your authorization.

I authorised the handling of my personaI authorised the handling of my personal data
for the above mentioned aims: