Registration Form for Technical Visits

Tuesday November 6th at 10.30

Please complete one form per person and send it back by 5th October 2012
to Ms Natacha Montelatici via e-mail: fnovaretti@gouv.mc
or by fax: (+377) 92 16 61 35

PARTICIPANT INFORMATION

PARTICIPANT :
(*) required field

Mr. Ms

Surname : *

First Name : *

Telephone : *

Email : *

Please note : limited places available for each visit.

Please select only one of the 4 visits below

1- UIRUI and CCFU (10p) : * YES NO

2- Grimaldi Forum Heat PUMP (20p) : * YES NO

3- Solar Panels (15p) : * YES NO

4- Test of Electric Vehicles: * YES NO

Jacket size (1) : * S M L XL

Shoes (1) :*

US Size

(1) Only for UIRUI and CCFU visit

Remarks :

- No minimum number of persons required

- All visits will leave from the Meridien Beach Plaza Hotel

- Should you wish to cancel a reservation, please contact Natacha Montelatici via email as soon as possible at : fnovaretti@gouv.mc or by Fax : (+377) 92 16 61 35

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