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.
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