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
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
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