|
Name/Surname*
|
| |
Sara Shakibania
|
|
Place of birth
|
| |
Tehran
|
|
Date of birth
|
| |
13/06/1994
|
|
Fiscal Code (Italy or 000000 if foreigner)
|
| |
44-100
|
|
Email
|
| |
sshakibania@polsl.pl
|
| FISCAL DATA |
|
Name/Surname – Company
|
| |
Silesian university technology
|
|
Address
|
| |
Ul. Akademicka 2A
Gliwice 44-100
Map It
|
|
VAT n. (only for company or University)
|
| |
631-020-07-36
|
|
Fiscal code (Italy of 000000 if foreigner)
|
| |
44-100
|
|
Payment
|
| |
Bonifico Bancario
|
|
Ordine
|
| |
| Prodotto |
Quantità |
Prezzo unitario |
Prezzo |
|
Registration on line (fee includes the possibility of poster submission)
|
1 |
200,00 € |
200,00 € |
|
No
|
1 |
0,00 € |
0,00 € |
| |
Subtotale |
200,00 €
|
| |
Totale |
200,00 € |
|
|
