Clone of XI Hotine-Marussi Symposium Registration Form

XI Hotine-Marussi Symposium Registration Form
Full name

TitleFirst NameLast Name
Institution / Affiliation
Email
example@example.com
Phone Number

Country CodeArea CodePhone Number
Billing Address
Invoice Header (Name or Institution for Invoice)
Street Address
Postal Code
City
Country
VAT Number (if available)
Codice Fiscale (mandatory only for Italians)
Codice Destinatario / Ufficio / PEC (if available, only for Italians)
Event Attendance and Social Activities
I will attend the meeting on
I will join the Social Tour
I will join the Social Dinner
Dietary requirements
Please list any allergy, intolerance, or special dietary requests
Registration fees include:
- symposium proceedings (IAG Series, on-line form)
- coffee breaks
- social tour and social dinner (not included in One-day registration)
- certificate of participation sent by e‑mail at the end of the symposium
* The Guided Tour and the Social Dinner are already included in the Delegate, Delegate – IAG, Young Delegate, Early Career Scientist and Retired registration fees.
Subject to availability. Priority will be given to multi‑day registrations.
Payment Method
Select Registration Fee
prevnext( X )
Delegate
€620,00



Delegate - IAG Member

€550,00



Young Delegate (age <35 at Symposium)
€300,00



Early Career Scientist

€300,00



Retired Scientist
€300,00



One-day
€150,00



Social Tour
Fee for one‑day registrants and accompanying persons.

The guided tour of Genoa is included in the Delegate, Delegate – IAG, Young Delegate, Early Career Scientist and Retired registration fees.

Subject to availability. Priority will be given to multi‑day registrations.

€20,00 Quantity



Social Dinner
Fee for one‑day registrants and accompanying persons.

The Social Dinner is included in the Delegate, Delegate – IAG, Young Delegate, Early Career Scientist and Retired registration fees.

Subject to availability. Priority will be given to multi‑day registrations.

€60,00 Quantity



Total

€0,00
Please complete the payment using the following bank details:

Bank: Banca Passadore & C.
Branch: Via E. Vernazza 27, 16121 Genova – Italy
Account Holder: EtaGamma srl
IBAN: IT50 I 03332 01400 000000946826
SWIFT/BIC: PASBITGG
Payment reference: XI Hotine-Marussi Symposium Registration + Full Name

Once the transfer has been completed, please send a copy of the payment receipt to segreteria@etagamma.it to finalize your registration.
Should be Empty:

XI Hotine-Marussi Symposium Registration Form

Billing Address

Event Attendance and Social Activities

Select Registration Fee