Blueprints For Making A Bench

Lacanian School of Psychoanalysis

MODERNITY 'OF PSYCHOANALYSIS

(in the clinic, culture, social issues)

Catania, 11 and 12 June 2011

Name ... .................................................. .................................................. ..

Address ........................................... .................................................. ............................

City ........................................... CAP ............................ ............... Prov. .......................

Tel .......................................... ................. Fax ................................................. ...............

e-mail ......................................... .................................................. ....................................

Code Tax or VAT (for issuing invoice) ......................................... ............

Request CME (physicians and psychologists )........ yes / no ......................... ......................

amount of the fee paid ........................................ ..........................................

Fees

€ 100.00 by 30/03/2011

€ 50.00 by 03/30/2011 for students (up to 26 years)

after 30.3.2011

€ 130.00

€ 70.00 for students (up to 26 years)

ECM .: If required more € 20.00.

.

Enrolment : Bank transfer to bank account in Lacanian School of Psychoanalysis, Deutsche Bank - H 468 Ag of Milan, IBAN code: IT76M0310401608000000821332 .

Important: specify the reason for the name and surname of those who enroll in the seminar, which is essential for those who use for the payment of an account which does not hold.

After payment of the bank fill out this registration form che potete inviare a: segreteriaoperativa@scuolalacaniana.it oppure per Fax al n . 02 54119539