XVIème CONFÉRENCE INTERNATIONALE
Cité du Vatican, Grande Salle du Synode
15-16-17 Novembre 2001
Formulaire d'inscription

SIXTEENTH INTERNATIONAL CONFERENCE
Vatican City Synod Hall
November 15-16-17, 2001
Registration Form

1. Please fill the form
2. The inscription form should be sent to us by October 20, 2001, in the amount of US$ 100.00 or the equivalent in local currency, in the following manner:

a. Those who register from outside Italy may pay an international cheque or international postal order, made out to: The Pontifical Council for Health Pastoral Care 00120 Vatican City

b. Those who register from Italy may use c.c.p. N°63353007, bearing the name:
Pontificio Consiglio per la Pastorale della Salute
Via della Conciliazione, 3
00193 Roma

3. After receiving the form and fee, written confirmation will be sent to the participants.

Nom de Famille/ Surname Prénom / Christian Name Profession /Qualification E-mail Adresse/ Address C.P. / Zip Code Ville / City Pays/ State Téléphone/ Telephone Télécopie/ Fax