Since 1966 – International School on Disarmament and Research on Conflicts – Italian Pugwash Group

Lecturers Information Form

Isodarco reserves the right to cancel the course, postpone it, or change the detailed program of the course depending on the development of the world health situation.

    Fields with an asterisk * are required.

    Personal Information for Lecturers and Guests

    Title *
    ProfDrMrMs
    Last (Family) Name *
    First (Given) Name *
    Present Nationality *
    Date of birth. Field required if you need our free Medical Insurance which is necessary for visa application.
    Place of birth
    Gender *
    MF

    Professional Qualifications

    Affiliation
    MAIL ADDRESS *
    HomeOffice
    Address *
    Zip Code *
    City *
    State and/or Country *
    Phone (e.g. +39 0663...)
    Mobile (e.g. +39 349...)
    Email *
    Additional Email
    The URL of your web page (if available)

    Do you need a visa to come to Italy?

    Where would you apply for visa?
    (if possible indicate the Email and full address of the Italian Consular Office where you will apply)

    Your affiliation as it should appear on the Isodarco web pages
    (Less than 100 characters name and spaces included)

    Notes

    By clicking “Send”, you express your consent to the processing of your data provided in this registration form, under the legal information provided in the “LEGAL INFORMATION PAGE” of the ISODARCO web site (www.isodarco.it), in compliance with the laws and regulations in force (Art. 13 and 14 of EU Regulation 2016/679).