Registration

EMMILE in libraries (and beyond)

Milan (Italy), February 27-29, 2012

 

(Per informazioni e modulo di iscrizione in ITALIANO cliccare QUI)

While attendees are to fund their participation on their own and cover travel costs and accommodation, NO registration fee is required for conference materials, coffee/tea-break and lunch as specified under “Programme“.

Registration is mandatory. All data will be confidentially treated, in full respect of the current Privacy Laws.

Conference registrations will be accepted on “a first come – first served” basis.

REGISTRATION FORM

(Registration is mandatory; NO registration fee is required)

Please, copy and paste the following text, fill in the form, mail it to the EMMILE Secretariat (secretariat.emmile@gmail.com) by Feb. 20, 2012:

FAMILY NAME _________________________________

FIRST NAME _____________________________________ MIDDLE NAME (if any) ……………………………..

TITLE (Dr, Prof, etc.) _____AFFILIATION _______________________________________________________

JOB TITLE/POSITION (e.g., School Teacher, Academic Librarian, Researcher, etc.) ______________________________________________________________________

CITY ____________________________________COUNTRY_______________________________________

ZIP CODE ___ e-mail ___________________________________Tel./Fax____________________________

I register in EMMILE as a member of:  IASL  IFLA  AIB  Other Library Associations or Projects (specify)  ________________________   EMPATIC Project

 I am not a Library Association Member

MAIN WORK SECTOR (tick only one):

 Teaching  Library  Research  Other (specify)_______________________

MAIN TARGET SECTOR (tick one or more):

 1) school  2) school library 3) public library  4) academic library

 5) research  6) health  7) adult education/lifelong learning  8) local community

 9) other (please specify) ________________________________________

My Arrival Date: DD/MM/YYYY – My Departure Date: DD/MM/YYYY

 I’ll be attending EMMILE

Feb. 27  morning  afternoon

Feb. 28  morning  afternoon

Feb. 29  morning  afternoon

Delegate Badge Information (as you want your name badge to read):

(please specify your Title, First Name, Family Name)

(Title/1st Name/Last   Name)

Affiliation:

Country:

I am interested in library visits [subject to availability of libraries. To be scheduled and confirmed]

 YES (please, specify your main interest) :

 1) school library    2) public library    3) academic library    4) Other _______________________

 NO

I am interested in taking part in the “EMMILE” Community (e.g., receiving and spreading information on further MIL – Media and Information Literacy initiatives, meetings, sharing materials etc.): YES (e-mail address: …………………………………………………………….. )  NO

I am interested in being actively involved in new MIL Projects: YES (e-mail address: …………………………………………………………….. )  NO

I agree to have my name and e-mail address listed in the participants’ list:   YES  NO

Comments/Special dietary needs: ____________________________________________________

Date, __________________________