Physics in Collision '98 WWW Registration Form:
Due before April 3rd 1998

Please fill the following application form.

First Name:   
Middle Name:  
Last Name:    
Arrival:       dd/mm/yy
              by plane by train by car
Departure:     dd/mm/yy
              by plane by train by car
Are you participating in the post-conference 
Gran Sasso visit?: Yes No 
Hotel Reservation:
Are you making your own hotel reservation?: Yes No

If yes, let us know the hotel you book: 
Do you want us to book for you at Villa Campitelli
under Physics in Collision arrangement? :Yes No

Room:  Single Double 
arriving:  departing:  dd/mm/yy
You will receive confirmation by E-mail within one week. 
Accompanying person: 

Any special requirement:

If you need at some time to change your registration form please send an E_mail to The E_mail must be originated from the same address you have
indicated on field of this form



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