Email registration

SCIFI-IT 2022 Submission Form

Title

First Name

Surname

Affiliation

Occupation and/or Title

Address

Zipcode

City

Country

VAT Number

Telephone

Fax

E-mail

EUROSIS member number

Extra's

Extra Conference Dinner Ticket - (April 15) for companion €60

Extra Conference Lunch Ticket - for companion €25/day

Extra Conference Visit Ticket - €20

Extra Conference Proceedings - €35

Add 21% Belgian VAT - OBLIGATORY

I am a vegetarian

I prefer hallal food

Payment method

I will pay by CREDIT CARD and fill in the information below

Type of card

Card number

Cardholder name

Expiration date

Verification code