Corresponding member - Società Italiana Statistica
annuncio pubblicitario
SOCIETÀ ITALIANA DI STATISTICA (ITALIAN STATISTICAL SOCIETY) Salita de’ Crescenzi 26 - 00186 Roma phone: +39 06 6869845 – fax: + 39 06 68806742 E-mail: [email protected] Web site: w3.uniroma1.it/sis CORRESPONDING MEMBER Application Form Name _________________________Surname __________________________________________ Place of birth ____________________________________________________________________ Date of birth______________________________________________________________________ Institution________________________________________________________________________ Address for correspondence___________________________________________________________________ ________________________________________________________________________________ e-mail___________________________________________________________________________ Phone ___________________Fax __________________ Date___________________________ Signature_______________________ Note ________________________________________________________________________________ ________________________________________________________________________________ ________________________________________________________________________________ ________________________________________________________________________________
