REGISTRATION FORM

This form should be print, completed in all its part and send to:
FASI Congress – Viale Gorizia 24c – 00198 Rome Italy
Tel. +39-068417001/068540296 fax +39-068414495

Please write or type clearly

NAME	…………………………………………………………..SURNAME……………………………………………..……….

INSTITUTION ……………………………………………………………………………………………………………..……….

ADDRESS……………………………………………………………..CITY……………….…………..COUNTRY…………….

TEL……………………….……………..FAX……………………………………………E-MAIL………………..………………..

REGISTRATION FEE (please tick the box)			

BY DECEMBER 15, 2002
Registration				  Euro 90,00
Registration + luncheons
(February 10,11,12)			  Euro 170,00

AFTER DECEMBER 15, 2002
Registration				  Euro 130,00
Registration + luncheons
(February 10,11,12)			  Euro 210,00

DAILY REGISTRATION*
Registration only			 Euro 60,00		DAY: 	 Feb. 10   Feb. 11   Feb. 12  
Registration + lunch			 Euro 90,00 		DAY: 	 Feb. 10   Feb. 11   Feb. 12  
* Daily registrations will be processed only if the day has been selected.

Please write or type details for invoicing:

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VAT NR.------------------------------------------------------------------------------------------------------

METHOD OF PAYMENT ( please indicate)

-     By bank transfer to: FASI Congress, Banca Poplare di Bergamo,
Ag. Nomentana, Account 92347; abi 05428; cab 03205
   (please include the copy of the bank transfer)

-	By credit card:	 	   Visa 	  Mastercard

CREDIT CARD NUMBER…………………………………………………………………………………………………………

CARD HOLDER…………………………………………………………………………………………….………………………

EXPIRE DATE	…………………………..AMOUNT…………………………………………………………………………….
I hereby authorise FASI Congress to debit this credit card account for the total amount due.

DATE…………………………………….SIGNATURE……………………………………………………………..………………

CANCELLATION POLICIES

Cancellations will be accepted ONLY in writing. 
Cancellation received 
-	within DECEMBER 20, 2002, 80% refund less secretariat expenses (euro 10)
-	within JANUARY 10, 2003: 50% refund, less secretariat expenses (euro 10)
-	after JANUARY 10, 2003 NO REFUND can be made

Having signed, I confirm that I have read and am fully aware of the cancellation conditions stipulated in this announcement.

Date____________________				Signature_________________________________

Registration form not accompanied by the registration fee will not be taken into consideration.