Registration form:This form must be completed in all its parts and sent to the email address fortmed2018@gmail.com with a copy of the bank transfer:Until Saturday, 09/06/2018 – for early registrationFrom 10/06/2018 to 10/10/2018 – for late registrationThe deadline for registration and payment of fee in order to have the paper published in the book of proceedings is Saturday, 30/06/2018.

INVOICE - PRIVATEPersonal detailsIndividual name____________________________________________________________________Paper’s Title_______________________________________________________________________Place and date of birth (dd/mm/yyyy)___________________________________________________Street Address_____________________________________________________________________Cod. fiscale o Partita Iva (se italiano) ____________________________________________________Fiscal Code (IVA or VAT) _____________________________________________________________University/Company affiliation (if any) __________________________________________________Other ____________________________________________________________________________

INVOICE - PUBLIC INSTITUTIONDetailsName ____________________________________________________________________________Street address _____________________________________________________________________City, Postal code, Country____________________________________________________________Cod. fiscale e Partita Iva (se italiano) ____________________________________________________Fiscal Code and VAT number__________________________________________________________Phone____________________________________________________________________________e-mail____________________________________________________________________________

REGISTRATION FEES (ONE CHOICE)Includes: Attendance to the Conference sessions (keynote, oral presentations, roundtable) Guided tour on Saturday 20th October 2018 Books with ISBN of the Conference proceedings Official certificate of Conference attendance Official certificate of oral presentation, if any Official certificate of the award, if any Coffee breaks and lunches on 18th and 19th October 2018

Early Registration (until June 9th, 2018)Full participant 190 €

Members of Scientific Committee 120 €

Student (under 30 years old) 120 €

Auditor (Books with ISBN of the Conference proceedings not included)

120 €

Normal Registration (Jun 10st to Oct 10th, 2018)30th June 2018 – Final date for payment of the registration fee in order to have the paper published in the proceedingsFull participant 250 €

Members of Scientific Committee 180 €

Student (under 30 years old) 180 €

Auditor (Books with ISBN of the Conference proceedings not included)

180 €

Gala dinner 60 €

additional paper (each paper must have at least one paying author)

70 €

METHODS OF PAYMENTPayment is possible by bank transfer only and must be made on the bank account below:

Politecnico di Torino - DADUNICREDIT BancaIBAN: IT63J0200801160000101739790BIC/SWIFT CODE: UNCRITM1AG0Payment Description: FORTMED2018 – NAME & SURNAME/TYPE OF ATTENDANCE (i.e. full participant) + GD (Gala dinner, if any)

Date _____________________ signature _____________________________