Please complete and return this form by November 25, 2016 to:

Registration Form

ASSOCIAZIONE ITALIANA DI METALLURGIA – via Filippo Turati 8 - 20121 Milano · Italy phone: +39 0276021132 - +39 0276397770 - fax: +39 0276020551 - e-mail: [email protected]

- website: www.aimnet.it/iwsq2016.htm

Registration fees

N.B.: All registration fees are revenue stamp included EARLY BIRD REGISTRATION FEES (by November 25, 2016)

speakers registration deadline:

November 15, 2016

DELEGATE STUDENT * € 200 Additional ticket for Social event: € 50 (22% VAT included) (Includes only the welcome & get-together cocktail on December 1). € 270 (after November 25, 2016 € 320) FREE € 290 € 360 (after November 25, 2016 € 410) € 190 (after November 25, 2016 € 240) Conference Registration fees include admittance to technical sessions, Conference bag with electronic proceedings, welcome & get-together cocktail on December 1, coffee breaks and lunch. For non-members the fee includes AIM Membership for the last quarter of 2016 and for the year 2017. * Students will have to provide valid proof of student status. Payment and remittance  by bank transfer, to the order of Associazione Italiana di Metallurgia - AIM at “Banca Popolare Commercio e Industria (UBI Banca)”, Branch no. 2 - Via Borgogna, 2/4 - 20122 Milano- Italy, account no. 000000022325 - cod. ABI 05048 - CAB 01602 - cin L, IBAN: IT92L0504801602000000022325, swift code BLOPIT22. The transfer order must specify the name of the delegate and the reference “IWSQ 2016”. A copy of the transfer order must be sent to AIM, together with the Registration Form.  by credit card online (www.aimnet.it/iwsq2016.htm). Personal and invoicing data To register please fill-in the following registration form in all its parts. (It is also possible to register online - www.aimnet.it/IWSQ2016.htm) Please use BLOCK letters throughout form (photocopies can be used) Family Name_________________________________________________________________________________________________________________ First Name(s) ________________________________________________________________________________________________________________ Company Name ______________________________________________________________________________________________________________ Company Fiscal Address _______________________________________________________________________________________________________ ZipCode ______________ Town __________________________________________________________ Country _______________________________ Tel.________________________________________________________________ Fax. ____________________________________________________ E-mail for correspondence _____________________________________________________________________________________________________ e-mail for invoicing and billing information _________________________________________________________________________________________ VAT and FISCAL CODE (if different) _________________________________ Order ref. number (if requested on the invoice) _______________________

You authorize AIM to the sending:

❏ ❏ ❏ ❏ ❏ ❏ I will attend the Conference as: □ Delegate (regular participant) □ Speaker □ Session Chairperson □ Student □ AIM Junior Member □ NON MEMBER □ AIM MEMBER €. ________________ €. ________________ €. ________________ €. ________________ Free n. _______ Additional ticket(s) for Social Event

Total amount being paid:

□ €. ________________

€. ________________

by bank transfer, to the order of Associazione Italiana di Metallurgia - AIM at “Banca Popolare Commercio e Industria (UBI Banca)”, Branch no. 2 - Via □ Borgogna, 2/4 - 20122 Milano- Italy, account no. 000000022325 - cod. ABI 05048 - CAB 01602 - cin L, IBAN: IT92L0504801602000000022325, swift code BLOPIT22. The transfer order must specify the name of the delegate and the reference “IWSQ 2016”. A copy of the transfer order must be sent to AIM, together with the Registration Form. by credit card online (www.aimnet.it/iwsq2016.htm).

Date _____________________________________________ Signature _______________________________________________________________