Registration Form

Personal data:

Family Name:        Age: 
First Name:         Sex: M  F
Nationality: 

Please, give a password that will allow you to edit and modify this document later.
Password:       
Password again: 

Academic position and institute

Please fill in information about your academic position. Clearly indicate where we can reach you in case of communication. E-mail is required.
Academic position: 
Home Institute: Address: Tel: Fax: Email: (format name@host.domain.country)

Registration

Please indicate to which activity are you interested in, by checking the appropriate button below:
5th Int'l Workshop on Pseudo-Hermitian Hamiltonians (3-5 July)
7th Bologna Workshop on CFT and Integrable Models (5-8 July)
Both conferences (3-8 July)

Talk/Poster

Are you interested in presenting a short communication/poster?

(Invited speakers: please tick the button "Talk".)

Talk Poster None
If yes, you must give a title.

Title:


Please give a short abstract of your talk/poster (formulae must be entered in latex):


Please indicate carefully when you prefer to present this talk/poster:
during the
5th Int'l Workshop on Pseudo-Hermitian Hamiltonians (3-5 July)
or the
7th Bologna Workshop on CFT and Integrable Models (5-8 July)

Arrival/departure

Note: if you plan to participate to both workshops please indicate here the true dates of arrival to the 1st and departure from the 2nd.

Date of arrival: Date of departure:

By which means of transport do you plan to come?
Train
Car
Airplane (Bologna airport)
Note: if you plan to arrive in another airport and then take the train, please check "train" here, and indicate in the "comments" below further details or need of help, if you wish. If you arrive in Forlì airport, please check "air" here and state explicitly in the "comments" below that you arrive in Forlì
Approximate time of arrival (hh:mm) :
Please feel free to add here any comments you may think useful, like particular accomodation or food needs, or details of your travel (Airplane no. - etc...)

Please, check the correctness of your data before submitting.