INVITATON LETTER REQUEST FORM

Please fill in one form per each person.
Please complete all fields marked (*)

Correspondence details: the information will be used to prepare your invitation letter.

"*" indicates required fields

Are you an Author?*

Yes

Paper number:

If yes Title of Paper:

Are you an Accompanying person?*

Yes

If yes Accompanying whom:

Are you an attendee without paper?*

Yes

Title (Prof.,Dr.,Ms.,Mrs.,Mr. ):*

Family Name:*

First Name:*

Organization:*

Department:

Address:*

Postal Code:*

City:*

Country*

E-mail:*

E-mail Please repeat e-mail address

Date of Birth:*

Place of Birth:*

Passport No.:*

Date of Issue:*

Expire Date:*

Issued by:*

INVITATION LETTER TO BE SENT TO

Email #1:*

Attention to:

Email #2:

Attention to:

Fax #1:

Attention to:

Fax #2:

Attention to:

Comment:

The information collected is subject to data processing to process your request of an Invitation Letter for VISA purpose. Without this information, we will be unable to properly process your request. Your personal data will be processed in compliance with the UE GDPR 2016/679 and will be used for circulation within the company for administrative activities. The data may be transmitted to external bodies which perform functions strictly connected and instrumental to service operations. In accordance with the chapter 3 of the European Regulation 2016/679 with regards to data protection, you have the right to request from SELENE Srl, access to and rectification or erasure of your personal data or restriction of processing concerning your data or to object to processing as well as the right to data portability. For such, please contact: selene@seleneweb.com

Privacy*

I permit the use of my personal data for any purpose related to obtaining the requested Invitation Letter (in compliance with UE GDPR 2016/679).

INVITATON LETTER REQUEST FORM

INVITATION LETTER TO BE SENT TO

ORGANIZING SECRETARIAT

SCIENTIFIC SECRETARIAT