Return this form and payment to:

PLEASE TYPE OR USE BLOCK LETTERS

Surname: _______________________ First Name_______________________________
 
Institute/ Company _______________________________________________________

Mailing address
__________________________________________________________________________

Postal Code/Zip code __________ City _______________

State/Country _________________

Phone business ______________ Fax _____________ Email: ___________________
 
Accompanying person
 
Surname ____________________ First name __________________________________
 
Only for Italian participants:
 
IVA _________________ C.F.: ______________________________

1) REGISTRATION FEE

            before August 1, 1999  after August 1, 1999     Total

Participants    Lit. 400'000           Lit. 450'000       Lit. __________

Students        Lit. 250'000           Lit. 300'000       Lit. __________
 

                                             (1) SUBTOTAL Lit. __________

2) HOTEL RESERVATION FORM

Hotel Prices (in Italian Lira)

Category   Single         Double              One Night Deposit

****       Lit. 420.000   Lit. 500.000     Lit. _________________

***        Lit. 300.000   Lit. 380.000     Lit. _________________

**         /              Lit. 250.000     Lit. _________________
 

                              (2) SUBTOTAL Lit. _____________
 

Rates are indicative and are per room, per night, including breakfast,
service, VAT

Arrival: September________ 1999 Departure: September ______ 1999

I wish to share my room with _________________________________________

3) SOCIAL PROGRAMME for ACCOMPANYIN PERSON

Number of person Total

- Social dinner at the Locanda Cipriani, Isle of Torcello ................

Lit. 140.000 per person

GRAND TOTAL

1. REGISTRATION FEE ................................... Lit. ____________

2. HOTEL RESERVATION .................................. Lit. ____________

3. SOCIAL PROGRAMME FOR ACCOMPANYING PERSON ........... Lit. ____________

4. HANDLING FEE (administrational cost), .............. Lit. 20.000
 

                                            GRAND TOTAL LIT. ____________

METHOD OF PAYMENT

All payments should be made in Italian Lire only: please mark payment
with your name and Company.

( ) Bank transfer to Key Congress srl - Padua Italy,
    Account no. 337803/. (ABI 06225) (CAB 12150) SWITH CRPDIT2P
    Be sure that all charges have already been paid.
    Don't forget to include a copy of your bank transfer.

( ) Please charge the amount of Italian Lire to my credit Card

    [ ] VISA     [ ] MASTER CARD

    Card Number ______________________ Exp. Date ______________________

    Card holder's address _____________________________

    Date _____________ Signature ___________________

No registration will be acknowledged until payment has been received.
 

Date _____________ Signature ___________________