University Information

University Name: *

Team Name: *

Team Car N°: *

Faculty Advisor Information

Name: *

Surname: *

Department:

Address: *

Post Code: *

City: *

District / Province: *

Country: * none selected Afghanistan Albania Algeria American Samoa Andorra Angola Antarctica Antigua and Barbuda Argentina Armenia Aruba Australia Austria Azerbaijan Bahamas Bahrain Bangladesh Barbados Belarus Belgium Belize Benin Bermuda Bhutan Bolivia Bosnia and Herzegovina Botswana Brazil British Virgin Islands Brunei Bulgaria Burkina Faso Burundi Côte D'Ivoire Cambodia Cameroon Canada Cape Verde Cayman Islands Central African Republic Chad Chile China Colombia Comoros Costa Rica Croatia Cuba Cyprus Czech Republic Democratic People's Republic of Korea Democratic Republic of the Congo Denmark Djibouti Dominica Dominican Republic Ecuador Egypt El Salvador England Equatorial Guinea Eritrea Estonia Ethiopia Fiji Finland France French Polynesia Gabon Gambia Georgia Germany Ghana Greece Greenland Grenada Guadeloupe Guam Guatemala Guinea Guinea Bissau Guyana Haiti Honduras Hong Kong Hungary Iceland India Indonesia Iran Iraq Ireland Israel Italy Jamaica Japan Jersey Jordan Kazakhstan Kenya Kiribati Kosovo Kuwait Kyrgyzstan Laos Latvia Lebanon Lesotho Liberia Libya Liechtenstein Lithuania Luxembourg Macao Macedonia Madagascar Malawi Malaysia Maldives Mali Malta Marshall Islands Mauritania Mauritania Mauritius Mexico Micronesia Moldova Monaco Mongolia Montenegro Morocco Mozambique Myanmar(Burma) Namibia Nauru Nepal Netherlands Netherlands Antilles New Caledonia New Zealand Nicaragua Niger Nigeria Northern Ireland Northern Mariana Islands Norway Oman Pakistan Palau Palestine Panama Papua New Guinea Paraguay Peru Philippines Poland Portugal Puerto Rico Qatar Republic of the Congo Romania Russia Rwanda Réunion Sào Tomé And Príncipe Saint Kitts and Nevis Saint Lucia Saint Vincent and the Grenadines Samoa San Marino Saudi Arabia Scotland Senegal Serbia Seychelles Sierra Leone Singapore Slovakia Slovenia Solomon Islands Somalia South Africa South Korea Spain Sri Lanka Sudan Suriname Swaziland Sweden Switzerland Syria Taiwan Tajikistan Tanzania Thailand Timor-Leste Togo Tonga Trinidad and Tobago Tunisia Turkey Turkmenistan Tuvalu US Virgin Islands Uganda Ukraine United Arab Emirates United Kingdom United States Uruguay Uzbekistan Vanuatu Vatican Venezuela Vietnam Wales Yemen Zambia Zimbabwe

Telephone: *

Fax:

E-mail: *

E-mail: *

Team Leader Information

Name: *

Surname: *

Department:

Address: *

Post Code: *

City: *

District / Province: *

Country: *

Telephone: *

Fax:

E-mail: *

Team Website URL:

The invoice will be issued to

University / Team Name: *

Department: *

Address: *

Post Code: *

City: *

District / Province: *

Country: *

VAT Nr. (EC only): *

Codice identificativo per fatturazione elettronica (ITALY ONLY):

Cod. Fiscale (ITALY ONLY):

E-mail Amministrazione (ITALY ONLY):

Payment method:

Bank transfer to: ANFIA Service Srl

Bank name: Cassa di Risparmio di Bra – Turin Branch - Corso Galileo Ferraris, 26 - Torino – Italy IBAN n.: IT04G0609501001000000003046 – Swift code: BPMOIT22. Please indicate on the bank transfer the following payment descriptions: Team name and University name. Payment must be received in full. ALL bank transfer charges must be covered by the payer.

Withdrawals

Registered teams that find that they will not be able to attend the competition are requested to officially withdraw by notifying the following by e-mail as explained in the rules.

Privacy Agreement: *

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