International Conference
Museums, libraries and archives online:
MICHAEL service and other international initiatives
Roma, 04-05 December 2006

(free entrance)

REGISTRATION FORM

Please return BEFORE 27 NOVEMBER 2006
to the fax number +39 06 68807662
or e-mail to: sara.moretto@bsmc.it 
(subject: Registration to MICHAEL Conference)

You must fill in this coupon for the entrance to the International Conference of MICHAEL. 

Registrations will be accepted until place availability.

Important: Filling in the form you can collect the bag with the information materials (until its exhaustion) and the badge for the entrance to the halls at the reception desk. 

First name___________________________________________________________________

Last name___________________________________________________________________

Company/Institution___________________________________________________________

Address____________________________ Postcode_________________________________

Town/City____________________________  Country _______________________________

Telephone (Country dialling code + number)________________________________________

fax (Country dialling code + number) _____________________________________________

e-mail ______________________________________________________________________

profession _____________________________________
		(please specify)

I’ll be present during these days: |_| December 04th   |_| December 05th    

How did you get information on this Conference?

|_| MICHAEL Website |_| Minerva newsletter |_| Press |_| other ___________________________________________
		 		                       (please specify)
Date______________Signature   ___________________________ 

Information and consent according to the law 31-12-1996, no. 675 “Protection of persons and other subjects with regard to treatment of personal information”

According to the above law we wish to inform you that the information contained in the registration form will be used by Minerva for statistical purposes, for the current registration, for the emission of a personal badge and for the sending of information about similar events.

Date______________Signature   ___________________________