Please fill the following application form.
First Name: Middle Name: Last Name: Institute: Address: City/Country: Phone: Fax: E-Mail: Arrival: dd/mm/yy by plane by train by car Departure: dd/mm/yy by plane by train by car
Are you participating in the post-conference Gran Sasso visit?: Yes No
Hotel Reservation:
Are you making your own hotel reservation?: Yes No If yes, let us know the hotel you book:
Do you want us to book for you at Villa Campitelli under Physics in Collision arrangement? :Yes No Room: Single Double
arriving: departing: dd/mm/yy
You will receive confirmation by E-mail within one week.
Accompanying person: none 1 2 3 more
First Name: Middle Name: Last Name: adults/children: adult child adult child adult child
Participation in social events:
Lunch at Laboratories Yes No Get-together at winery Yes No Social dinner Yes No Post-Conference Gran Sasso Laboratory visit Yes No
Any special requirement: If you need at some time to change your registration form please send an E_mail to pic98@lnf.infn.it. The E_mail must be originated from the same address you have indicated on field of this form