Application Form

Personal information (required)

Title

Name

Surname

Department

Institution

Street

Postal code

Town

Country

Phone

Email

Talk:

 I intend to give a short talk.
 I do not intend to give a short talk.

Title of the short talk:

Keywords (min. 3 max 5 words):

Abstract (half page):

By submitting this application form you authorise Fondazione Alessandro Volta to include your personal data on its mailing list for the distribution of information material. In accordance with the Law 196/2003, you may have access to these details at any time and request their modification and cancellation.