MODULO ADESIONE PER
NON DOCENTI
E
SIMPATIZZANTI
MEMBERSHIP FORM FOR
SUPPORTERS
AND
NOT TEACHERS
* Cognome/Surname:
* Nome/Name:
*Luogo e Data di Nascita/
Birthplace and Date
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*Nazionalità/Nationality:
*Indirizzo e CAP/Address and PostCode:
*Cittá-City/Provincia-Province
Stato-Nazione/State-Country:
Tel e pref/Tel with prefix:
Num Fax/TeleFax:
Posta El/E-mail:
SitoWeb/Possible WebSite:
Tit Studio-Istruz/Education-Studies:
Universitario - Education/Studies
Parauniversitario - Short degree course
Diploma secondario sup. - High School diploma
Lo scrivente è/
My position is
Direttore-Resp Istituzione/Institution Resp Director
Coordinatore-Resp Linguistico/Resp LinguistCordina
Studioso-ricercatore scient/Univ Scient Researcher
Professionista/Professional
Simpatizzante-sostenitore/Patron-supporter
Studente Univ/Univ Student
Docente di italiano/Teacher of Italian
Desidero iscrivermi ora/I desire to enroll now: