NEUROHIV 2017 SEVENTH INTERNATIONAL MEETING

Online Registration Form


Please fill in the Form and click the button "SUBMIT FORM" at the end of this page.
All fields are mandatory.

Registrations are confirmed only after receiving payment confirmation.
PERSONAL INFORMATION




*Please, specify a profession.











INVOICE INFORMATION (MANDATORY)













*VAT Exemption requested (ART. 10c. 20 D.P.R. 637/72)
MORE INFORMATIONS
PARTICIPATION FEE

Partecipation Fee

427,00 ( 350,00 + VAT 22%)

METHOD OF PAYMENT
Cheque or Bank Transfer:
Banca Ubi Banca - Filiale Pavia Porta Cavour
Cab 11305 - Swift Code: BLOPIT22634 - IBAN: IT48A0311111305000000030112
headed to Nadirex International S.r.l.

The cheque or copy of the bank transfer must be sent to the Organizational Secretariat. No registrations will be made without payment.
Credit Card:
You will be redirected to the Nadirex International Website in order to proceed to the online payment

DATA PRIVACY Pursuant to Legislative Decree no. 196/03 (Regulations concerning data privacy) we inform you that we will use your personal data lawfully and fairly in full respect of your rights, in particular your privacy and personal identity.

Nadirex International S.r.l. (Via Riviera n. 39, 27100 Pavia - Italy) may use such information solely for purposes related to the management of the Conference, and may pass it on to third parties, including the Italian fiscal authorities, if so required by the law or if necessary for the carrying out of this contract.

The Secretariat has, to the best of its ability, taken all appropriate measures to eliminate or minimize the risk of improper or unauthorized use of your personal data and to guarantee the accuracy of such data.

I declare I have read this present document that I have understood each clause and undertake to comply with every aspect of the agreement.
All information given on this form is correct.