Transcript congress registration form

AUTOMATION INSTRUMENTATION SUMMIT
CASTELLO DI BELGIOIOSO, Pavia, Italy
5 - 6 July, 2017
CONGRESS REGISTRATION FORM
[email protected] - www.aisisa.it
To avoid queuing up at the registration desk please fill in this form online at www.aisisa.it or send it
by e-mail to [email protected] - you will get your badge directly at the conference venue
Surname/Name____________________________________________________________________________
Company____________________________________________ ______________________________________
Street_____________________________________________________________________________________
Postcode________________ City_____________________________________ Country___________________
Phone__________________________ e-mail_____________________________________________________
I will take part to the Conference on (please tick appropriate):
( ) Wednesday July, 5 2017
( ) Thursday July 6 ,2017
I am interested in the following workshop session/s (please tick appropriate):
(
(
(
(
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) ADVANCES IN CONTROL SYSTEMS
) CONTROL AND PLANT COMMUNICATION
) THE INDUSTRIAL INTERNET OF THING, 4.0, CYBERSECURITY
)INSTRUMENTATION AND ANALYZERS TECHNOLOGY EVOLUTION
) BUSINESS AND MANAGEMENT
I will take the shuttle bus from Milano (please tick appropriate):
( ) Porta Garibaldi Station
( ) Hotel Visconti Palace, Viale Isonzo
( ) No need of shuttle bus
Signature
Place, Date
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Organizer: AIS –ISA Italy Viale Campania 31 – 20133 Milano - Tel: +39 02 54123816