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November 10-13, 2004 - Florence, Italy
REGISTRATION FORM
Please compile the form and send it back to: Newtours, Via Augusto Righi 8, 
50019 Osmannoro, Sesto Fiorentino, Florence, Italy.
 
Family Name First Name
Institute
Address of Institute
Postal code City
Country Phone
Fax E-Mail
 
The invoice should be addressed to:
Institute (or name of the person)
Address Postal code
Town
VAT number
Fiscal code
(for Italian participants)
 
ACCOMPANYING PERSON(S):
1. Family Name First Name
2. Family Name First Name

Registration fee (in Euro)
(Please tick where appropriate)
From July 1 to
November 5, 2004
Participant from a high income country*
650,00
Participant from an upper-middle income
country*
530,00
Participant from a lower-middle income
country*
410,00
Participant from a low income country*
300,00
Trainee or student**
300,00
Accompanying person
200,00
 
* See list of countries
** Please attach a copy of the student card or a certificate by the chairperson of the Department
 
I wish to participate in the following Advanced Course(s):

Drake
Wasserman
Carmi
Markowitz
Fulford
Galderisi
 Wednesday, November 10, 

2004 from 09.00 to 12.00

Naber

Arboleda-Florez Harnois Cournos Tyano Wednesday, November 10, 

2004 from 14.00 to 17.00

Thornicroft

Thursday, November 11, 
2004 from 15.15 to 18.15
Brockington

Sartorius

Friday, November 12, 
2004 from 15.15 to 18.15
The fee for each Course is Euro 60,00
I wish to attend the Welcome Reception
 
I wish to attend the Concert
 
I wish to attend the Congress Dinner
(Fee Euro 80,00)
I wish to participate in the
Uffizi Gallery Tour
Nov 11
Nov 12
Nov 13
(Fee Euro 30,00)
I wish to participate in the
Academy Gallery Tour
Nov 11
Nov 12
Nov 13
(Fee Euro 30,00)
I wish to participate in the Pitti Palace Tour
Nov 11
Nov 12
Nov 13
(Fee Euro 30,00)
 
FOR ACCOMPANYING PERSONS
I wish to attend the Welcome Reception
No. of persons
I wish to attend the Concert
No. of persons
I wish to attend the Congress Dinner
No. of persons (Fee Euro 80,00)
I wish to participate in the City Centre Tour
No. of persons
I wish to participate in the Florentine
Hills Tour
No. of persons
I wish to participate in the Uffizi Gallery Tour (on November 12)
No. of persons
     
I wish to participate in the following tours:    
Masaccio and Churches in the
Oltrarno area
 
NOT CONFIRMED
Santa Maria Novella, its cloister and the Pharmacy
 
NOT CONFIRMED
Siena and San Gimignano
No. of persons
Florentine Gardens NOT CONFIRMED
San Lorenzo Church and Medici-Riccardi Palace
No. of persons
Bargello and Cathedral Museums
 
NOT CONFIRMED
San Marco Museum and SS. Annunziata Square
 
NOT CONFIRMED
Pisa and Lucca
No. of persons
Uffizi Gallery 
Nov 11
Nov 13
No. of persons
Academy Gallery
Nov 11
Nov 12
Nov 13
No. of persons
Pitti Palace
Nov 11
Nov 12
Nov 13
No. of persons
         
TOTAL PAYMENT
Euro
Bank Transfer to: INTESA, Viale Gramsci, 39/41, Florence; Account number: 78/158;
Abi: 3069 / Cab: 2820; Swift: B C I T I T 3 3 4 5 7; IBAN: IT30 Y030 6902 8200 0000 0078 158
Bank Cheque payable to Newtours S.p.A.
American Express
Visa
Diners Club
Eurocard (Mastercard)
Credit Card
Card holder’s name
Card number
Expiration date
For Italian participants only: I authorize Newtours S.p.A. to use my personal data for purposes connected to the Congress
management.