In order to register to the EGPA Modena 2016 workshop AFTER FEES PAYMENT,  please fill all the following required information.
If you need an invoice for the payment please write us an email with all your data(egpamodena2016@unimore.it).

 

Name

Surname

Email address

Position

University/Organization

Work address

Telephone

Fees payment: [Please write the bank transfer number or credit card
payment information ATTESTING YOUR FEES PAYMENT]

Presenting a paper

yesno

Attending to the social dinner (Thursday 5th May)

yesno

Accompanying person

yesno

Food intollerances/Special requirements

Comments/Other