PARTICIPANT INFORMATION

Please send information to :	Didattica della Storia ISAGA 2001//Secretary Angelo Filograsso, Loredana Caradonna Department of Historic and Social Sciences//University of Bari Piazza Umberto 1° 70100 BARI, ITALIA
	t +39/080/5714677 f +39/080/5714679 e mail isaga2001@ateneo.uniba.it

1. Name ...........................................................................................................................................
2. Organisation.................................................................................................................................
3. Full Address .................................................................................................................................
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Country.........................................PN/ZIP Code...............................................................................
4. Phone with area code ..................................................................................................................
5. Fax ................................................................................................................................................
6. E-mail ...........................................................................................................................................

BRIEF PARTICULARS(For Foreign Delegates Only)

1. Full Name (Expanding the initials).................................................................................................
2. Nationality ......................................................................................................................................
3. Date and Place of Birth .................................................................................................................
4. Present Address ...........................................................................................................................
5. Permanent Address ......................................................................................................................
6. Passport No., Date & Place of Issue, Expiry Date........................................................................
7. Occupation ...................................................................................................................................
8. Whether accompanied by spouse?..............................................................................................