TED06 

TOWARDS E-DEMOCRACY:PARTICIPATION, DELIBERATION, COMMUNITIES 

           October 24-26, 2006  -  Mantova,Italy

REGISTRATION FORM

to be sent to 

TED06 Secretariat
E-mail: ted06@mi.imati.cnr.it
Fax   : +39 0223699538

Family name         : _____________________________________________
First name          : _____________________________________________
Institution         : _____________________________________________
Department  	    : _____________________________________________
- Mailing address   : _____________________________________________
- City              : __________________________ Code: ____________
- Country           : _____________________________________________
- VAT number(if any): _____________________________________________ 
Telephone           : _____________________  Fax : ________________
E-mail              : _____________________________________________     
Student             : ________________   Advisor   : ______________

Please mention if you have any particular request (e.g. vegetarian
meals,facilities for disabled people, accompanying person, etc.)
___________________________________________________________________
___________________________________________________________________
___________________________________________________________________

REGISTRATION FEE 

Participant           :   Euro _______ (50 students and postdocs)
                                       (150 others)

Late registration fee :   Euro _______ (50 after September, 20th)
_________________________________________________________________

Total                 :   Euro _______

I paid the registration fee                        [ ]

I sent by fax (+39 0223699538)                     [ ]
a copy of the bank transfer to

Banca Nazionale del Lavoro
Sportello 6392
Roma (Italy)
Account nr. 218155 - ABI 01005 - CAB 03392
IBAN: IT57S0100503392000000218155
SWIFT/BIC: BNLIITRR
Holder of the account: Consiglio Nazionale delle Ricerche

It is important to indicate in the Bank Transfer:
YOUR NAME and "TED06 - CNR IMATI - 050.001"