CALRE 2016 PLENARY ASSEMBLY

November, 24 - 26 2016 | Villa Andrea, Ville Ponti Congress Centre, Piazza Litta 2-21100 Varese, Lombardy

Registration Form

CALRE members

Section A - Registration Form

Parliament
Region
State
Contact person
tel.
e-mail

president

Name and Surname
Address
tel.
e-mail

Delegation - members n......

Name and Surname
Role
e-mail
Name and Surname
Role
e-mail
Name and Surname
Role
e-mail

accompanying delegation - members n......

Name and Surname
Role
e-mail
Name and Surname
Role
e-mail
Name and Surname
Role
e-mail

Section B - Logistics Information Sheet

TRAVEL INFORMATION – Please fill in the relevant tabs

By plane

Arrival in Milan / Date / Time / Flight no.
Departure from Milan / Date / Time / Flight no.

By Train

Arrival in Milan / Date / Time
Departure from Milan / Date / Time

By Car

Arrival in Milan / Date / Time
Departure from Milan / Date / Time

ACCOMMODATION DETAILS – Please complete the name and details of the Hotel booked for the event

Hotel / nights
Check in / Check-Out

For the hotel choice in Varese, in particular for a hotel close to the event venue, please refer to the Accomodation information material provided by the organizing unit.

Section C - detail on the stay

Depending on your travel needs and availability, please specify which parts of the event you are planning to attend.

Day 1 - Thursday November 24, 2016

□ Yes □ No / Light lunch / November 24, h 13:30 / Villa Andrea, Varese
Notes
□ Yes □ No / Cocktail hour / November 24, h 19:00 / Villa Andrea, Varese
Notes

Day 2 - Friday November 25, 2016

□ Yes □ No / Visit to the JRC Ispra
(Presidents only)
Details about the visit’s program will follow. / November 25, h 9:00 – 14:00 / Ispra, Varese
Please provide by October, 28 2016 a scanned copy of the passport or of another valid ID document of the President participating in the visit to the JRC in Ispra in order to register for the access to the buildings.
□ Yes □ No / Dinner / November 25, h 19:30 / Villa Andrea, Varese
Notes

Day 3 - Saturday, November 26, 2016

□ Yes □ No / Cultural program / November 26, h 9:00 – 13:00 / Varese
Specify number of people

Further information

□ Yes □ No / Food allergies and intolerances
Please specify any intolerance and/or food allergies

Notes:

Section D - Participation Fee

Amount of participation fee

President / Head of Delegation / € 350,00
Accompanying members / € 150,00 per person

Payment

The payment can be made by wire transfer to the Regional Council of Lombardy, to the following bank account:

IBAN / IT92W 0306909790 000000007952
Bank / Banca Intesa Sanpaolo
Specify name and other relevant information about the contact person
Description of payment / "CALRE 2016 Plenary Assembly Participation fee"
Please specify: / □ President | No. of accompanying members ......

This event will be documented by pictures and videos. By participating you declare to agree that pictures and video recordings may be used and published, according to relevant laws.

…………………………………………….

(Signature)

Please complete and return this application form

to the Regional Council of Lombardy - Institutional Relations Unit

e-mail: