DASI'06 Application Form TO BE SENT TO lenzerini@dis.uniroma1.it International School on Data and Service Integration 10-15 December 2006, Bertinoro University Residential Center, Italy (DASI'06 is a BICI -Bertinoro International Center for Informatics- event) First Name: Last Name: Sex (M/F): Date of birth: Place of birth: Nationality: Position: Affiliation: Address: City/State: Zip Code: Country: E-mail Address: Fax: Please select one: [__] I request a single room (if requesting a grant leave this option blank) [__] I will share the room (double) Please select one: [__] I request no grant. [__] I request a Leonardo Melandri partial participation grant (specify amount, up to 350 Euro): ___ Euro. [__] I request a Leonardo Melandri full participation grant (specify amount, up to 650 Euro): ___ Euro. [__] I request a Leonardo Melandri travel grant: ___ Euro. (this grant will be accorded to exceptional cases only: justify in the CV) If you request a grant, please include a brief curriculum vitae and arrange for at least one letter of recommendation to be sent to the School Director, prof. M.Lenzerini (email is fine:lenzerini@dis.uniroma1.it). Curriculum vitae: