Pre-registration Form

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A - Institution

Name 

Address     City/Town 

Post Code     Country 

Phone       Fax    e-mail 

Partner  Associated Partner  Participant  Non Member


B - Teacher

First Name     Last Name 

Phone    Mobile Phone    e-mail 

Gender         Particular needs 


C - Students

Student n. 1

First Name     Last Name 

Gender     Age     Particular needs 

 
Student n. 2

First Name     Last Name 

Gender     Age     Particular needs 

 
Student n. 3

First Name     Last Name 

Gender     Age     Particular needs 

 
Student n. 4

First Name     Last Name 

Gender     Age     Particular needs 

 


D - Comments

Enter your comments in the space provided below:

To submit by not later than August 31st, 2008

 

 


Last updated: 2009-12-26
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