Registration

To register, please print, fill and send by fax to the "Unione Matematica Italiana" the form below.

Conference Fee [*]
Date of registration AMS or UMI members Others
until March 31, 2002 100 120
until May 31, 2002 150 170
on site [**] 180 200
[*] In Euro currency. (1 Euro = 0.8534 US$ as of June 22, 2001)
[**] Please note that payment will be accepted by cash only at the Meeting site.

Registration Form
Meeting UMI-AMS, Pisa, Italy, 12-16 June 2002

Sent via fax to
Unione Matematica Italiana
Fax +39 051 4214169

 

Title ...... Last name ......................... First name .................

Affiliation .................................................................

Address .....................................................................

Zip code ............ City .................... Country .....................

Tel .................... Fax .................... E-mail ....................

Arrival date ............ Departure date ............ Accompanying person ...

Session of interest .........................................................

[] American Mathematical Society

[] Unione Matematica Italiana

Method of payment

[] By bank transfers to the following account:
Banca Nazionale del Lavoro
Via Rizzoli, 26
I - 40124 Bologna
"Joint Meeting AMS-UMI": IBAN IT25 A010 0502 400 0000 0059 067 swift/bic BNLIITRR

By Credit card

Last name ......................... First name .................

Place and date of birth ........................................

Permanent address ..............................................

................................................................

Passport (or other identification document) n...................

[ ] Visa [ ] Mastercard

Card Number ................................

Expiration date ............................

[ ] I AUTHORIZE Unione Matematica Italiana
to withdraw from the credit card above-mentioned the amount of:

Euro ......,00 (......................................./00)

Date ................ Signature ..........................................


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