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Ramazzini Days 2017 Conference Registration
Registration Deadline 17 September 2017

ONLINE REGISTRATION (open July 17 - September 17)

Fellows are invited to complete the registration form as they would like their contact information to appear in the Collegium Ramazzini membership roster.

Once your registration has been received and processed, you will be sent a personalized confirmation e-mail. If you have not received this confirmation within one week after the date of your registration, please send an email to events@ramazzini.it.

PARTICIPANT INFORMATION

required fields*

Title: *
Last name: *
First name: *
Affiliation/Organization: *
Mailing Address: *
Postal Code: *
City: *
State or Province: *
Country: *
Telephone: *
Cellphone:
E-mail: *
E-mail assistant
for copy of conference information:

please check all that apply:

I am a Fellow of the Collegium Ramazzini who is eligible to receive institutional support or reimbursement for my conference participation (registration fee 750 USD). Fee includes conference meals, materials, local ground transportation and lodging.
I am a Fellow of the Collegium Ramazzini who is individually responsible for my conference participation (registration fee 600 USD). Fee includes conference meals, materials, local ground transportation and lodging.
I will be accompanied by a spouse or guest (spouse/guest fee 300 USD).
Fee includes conference meals, materials, local ground transportation and lodging.

Name of guest:
I am not a Fellow of the Collegium Ramazzini (external fee of 400 USD). Fee includes conference meals, materials and ground transportation. Lodging excluded.
I prefer vegetarian meals
I have other special needs (please specify below)

TRAVEL INFORMATION

Arrival

Thursday, 26 October 2017
Bologna International Airport
Airline:
Flight #:
Arrival Time (0:00-24:00):
Modena Centrale Train Station
Arrival Time (0:00-24:00):
Carpi Train Station (I will walk 1 block to the Hotel Touring)
I will arrange my own ground transportation to Carpi
I will use the conference-provided shuttle from the historical center of Bologna
I have other travel plans as indicated:

Departure

Sunday, 29 October 2017
Bologna International Airport
Airline:
Flight #:
Departure Time (0:00-24:00):
Modena Centrale Train Station
Departure Time (0:00-24:00):
Carpi Train Station (I will walk 1 block from the Hotel Touring)
I will arrange my own ground transportation from Carpi
I will use the conference-provided shuttle to the historical center of Bologna (available Sunday only)
I have other travel plans as indicated:

Monday, 30 October 2017
Bologna International Airport
Airline:
Flight #:
Departure Time (0:00-24:00):
Modena Centrale Train Station
Departure Time (0:00-24:00):
Carpi Train Station (I will walk 1 block from the Hotel Touring)
I will arrange my own ground transportation from Carpi
I have other travel plans as indicated:

 

Questions? Comments! Mail to: events@ramazzini.it