REGISTRATION FORM

FROM SEED TO PASTA & BEYOND
A Sustainable Durum Wheat Chain for Food Security and Healty Lives

Milan (Italy), 31 May – 3 June 2015
ONLINE REGISTRATION FORM * Required information
SURNAME *
FIRST NAME *
TITLE
INSTITUTION *
ADDRESS * N.
CITY
COUNTRY
ZIP CODE*
TELEPHONE
MOBILE
FAX
EMAIL *
INVOICING *
REGISTRATION FEES
PARTECIPANT OF PUBLIC INSTITUTION
Before 15 March 2015 € 350,00
After 15 March 2015 € 420,00
PARTECIPANT OF INDUSTRIES
Before 15 March 2015 € 410,00
After 15 March 2015 € 480,00
STUDENTS and YOUNG SCIENTISTS (< 30 years old)
Before 15 March 2015 € 250,00
After 15 March 2015 € 320,00
ACCOMPANYING PERSON
Accompanying fee € 90,00
OPTIONAL EVENT
Gala Dinner (1 June 2015) € 70,00
Expo Day (3 June 2015) € 50,00
OPTIONAL TOUR
BOLOGNA GOURMET (1 June) € 60,00
BOLOGNA CLASSICAL TOUR (1 June) € 50,00
MOTOR VALLEY (2 June) € 90,00
METHODS OF PAYMENT
Bank Cheque to Avenue Media srl
Wire Transfer to Avenue Media srlBank details: CARIPARMA Crédit Agricole Ag. Bologna Sede, via Marconi 16 (Bologna)

IBAN: IT 71 C 06230 02402 000056506569 –

SWIFT CODE: CRPPIT2P522

Postal Account n. 18182402 – Avenue Media srl.
Please, specify “FSTP15 + Surname of the participant”
Credit Card (Visa-MasterCard-American Express)
Privacy Law
Privacy ActData marked by a (*) are not compulsory. However, failure to provide this data undermines the effectiveness and performance of the service. Data without (*) are used for administrative and fiscal purposes; you need to provide
it in order to be enrolled.
All the data will be gathered and processed (both manually and by computer) in compliance with the Italian legislative decree No.196/2003, also for the purpose of sending information and/or promotional material.
Data
will not be disseminated to external bodies, except for banks, mail delivery companies, service management companies appointed by Avenue Media, the Congress Scientific Secretariat and/or Organizing Committee.
You are entitled to ask Avenue Media to update or delete your data or you can deny your permission to use it by writing to the company in charge of data processing: AVENUE MEDIA S.R.L., VIA RIVA RENO, 61 – 40122 BOLOGNA – ITALY (avenuemedia@avenuemedia.eu).
You can find the entire law text containing the statement of your rights on our Web site: www.avenuemedia.eu – see “Privacy Act“.
I HEREBY AUTHORIZE YOU TO USE AND PROCESS MY PERSONAL DETAILS* Yes No