Application Form
           (Submission Deadline: 11 March 2007)

     7th INT. SCHOOL ON FORMAL METHODS FOR THE DESIGN OF 
        COMPUTER, COMMUNICATION AND SOFTWARE SYSTEMS:
              PERFORMANCE EVALUATION (SFM-07:PE)

           Bertinoro (Italy), 28 May - 2 June 2007


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PERSONAL DATA
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FIRST NAME:          ___________________________________
FAMILY NAME:         ___________________________________
MALE/FEMALE:         ___________________________________
DATE OF BIRTH:       ___________________________________
PLACE OF BIRTH:      ___________________________________
NATIONALITY:         ___________________________________

POSITION:            ___________________________________
AFFILIATION:         ___________________________________
ADDRESS:             ___________________________________
ZIP CODE:            ___________________________________
CITY:                ___________________________________
STATE:               ___________________________________
COUNTRY:             ___________________________________

E-MAIL:              ___________________________________
PHONE:               ___________________________________
FAX:                 ___________________________________


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FEES
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Registration fee:                              550 euros

Accommodation fee (bed, breakfast and lunch):  350 euros
Reduced accommodation fee (only lunch):        100 euros


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GRANTS
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Please select one:
1. I request no grant.
2. I request a grant for my registration fee
   (specify amount, up to 550 euros):          _________