infoiasl23@unicusano.com

23rd IASL, World Congress, 2017 in Rome
PROGRAMME APPLICATION

Please complete all sections and enter "Not Applicable" or "N/A" as needed.

SECTION 1: PERSONAL DATA

Given name

FAMILY NAME(S) IN CAPITAL LETTERS

Phone (primary)

Email

Citizenship (primary)

Country of Permanent Residence

* Passport that you will use to enter to European Union.

Country of Birth

Middle name(s)

SEX
FemaleMale

Phone (other)

Alternative Email

Citizenship (other)

City of Birth (other)

Date of Birth

Personal postal address

(Please list a location at which you would be able to receive critical visa-related documentation up to the date of your planned departure.)

Name

Street 2

State/Prov.

Postal code

Street 1

City

Country

SECTION II: OTHER INFORMATION

SECTION III: PROGRAM BOOKING

Participation Fee Cost per person
Entire Registration Fee €. 220,00
Members Fee €. 110,00
Young Lawyers and Ph.D. €. 110,00
Early Registration Fee (expires June 30th - 15% discount on the entire registration fee) €. 190,00
Daily Registration Fee €. 75,00
Total

IMPORTANT
Please, note that for the accommodation the webpage is the following: https://www.ihg.com/crowneplaza/hotels/us/en/rome/romsp/hoteldetail you are invited to insert in the space GROUP CODE your reservation code that is: GBV

Terms & Conditions
All prices quoted are in € Euro (CE).
Meetings fees are all-inclusive and cover materials, facilities and meals as specified in the programme.

Wire Transfer Instructions
Bank Name: Monte Paschi di Siena
Beneficiary Account Number/IBAN: IT15D0103003284000061306964
Beneficiary Bank Swift Code/BIC: PASCITM1A27
Reason of payment: Name & Surname + IASL23

Once made the payment by wire transfer, please upload the file with the proof of transfer.
Registration will be incomplete without payment of registration fee.
Please, contact us for further information.
email: infoiasl23@unicusano.com

Form completed on date

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