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Registration Form. AutoNet 7th Match making event Hybrid and electric vehicles and components 2- 3 July 2012 Stezzano , Bergamo. Please fill in this form and send it via email by 22 JUNE to : michelacavallini@michela.e.telefonica.net Date of arrival and date of departure:

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Registration Form

AutoNet

7th Match making eventHybrid and electric vehicles and components

2- 3 July 2012 Stezzano, Bergamo

  • Please fill in this form and send it via email by 22 JUNE to:
  • michelacavallini@michela.e.telefonica.net
  • Date of arrival and date of departure:

Participant1............................................................/................................................................

Participant2....................................................../..............................................................

I authorise, according to Italian Privacy Law n. 675/96 art. 10 and n. 695/96 art. 13, the tratement of my personal data to the only scope of the registration to the above-mentioned event. These data will be archived by the event management company.

Company/Organisation Name: …………..

Address: ……….. Country:…………………..

Participant 1 and function: …………………..

Participant 2 and function: ………………………

Tel.: ……………………………………………………………Fax:…………………………………………………………..e-mail: …………………….

Contact mobile.: ....................................................................................................................

  • 3 July – Matchmaking
  • Yes/No…… Participant 1………………………………………………….........................
  • Yes/No…… Participant 2………………………………………………………......................
  • 2 July – site visit to BREMBO Spa
  • Yes/No……Participant 1…………………………………….........................................
  • Yes/No…….Participant 2………………………………………………………………………………
  • 3 July – Plenary session
  • Yes/No……Participant 1…………………………………………………………………….................
  • Yes/No……Participant 2……………………………………………………………………………
  • 3 July – Get-together dinner
  • Yes/No……Participant 1……………………………………………………………………..
  • Yes/No……Participant 2……………………………………………………………………..

………………………………………….. …………………………………………………..

Date Signature

Contact

Mic hela Cavallini

Ph. +34 634341199

michelacavallini@michela.e.telefinica.net