URBE - Registration form

URban freight and BEhavior change

Please fill the empty spaces and
click "submit" when you've finished.

Make sure you provide the compulsory (*) data,
otherwise your registration form won't be succesfully submitted.

You will be asked to send
a copy of your bank transfer receipt
so, please, have it at hand.

If you have any questions or comments
feel free to contact the URBE Committe at

urbe_secretariat@uniroma3.it
+39 06 57335411

Via Gabriello Chiabrera, 199
00145 Rome, Italy
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Participant registration
Last name *
First name *
Title
Clear selection
Affiliation *
Address
E-mail *
Phone number
Mobile phone
Postal address
Accompanying person
Last name
First name
Title
Clear selection
Special requirements
Partecipant and/or accompanying person
Vegetarian, celiac or special alimentation needs
(if yes, please specify requirements):
Weekday childcare facilities
(if yes, please specify number and age of the children):
Disabilities
(if yes, please specify requirements):
Other
(please specify):
Social dinner
Charge 75€ by person *
Not included in the conference registration fee.
If yes, please specify the number of reservations
Payment
Cancellation and refund policy *
Cancellations must be received in writing to urbe_secretariat@uniroma3.it  Registration fees are non-refundable after September 15th, 2015. There will be a 50€ service fee on all cancellations.
Required
Fee *
Choose the option that suites you the most from the list below.  For more information visit http://host.uniroma3.it/eventi/urbe/registration.php
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