Liophant Simulation Club

To register yourself to the Club you need to submit the following application form by mail/email or fax. 
The Members of the Liophant Simulation Club can use the symbols and the arms of the Club; the Club have official T-shirts, tilts, pins, suites and flags, sculptures.

Please send the payment (20USD or 20Euro)

by cheque to Liophant Simulation Club, c/o Agostino G. Bruzzone, New Campus University of Genoa, via Molinero 1, 17100 Savona, Italy

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Liophant Simulation Club Application Form

First Name:________________________  Last Name: _________________________________

Affiliation:__________________________________________    Position: __________________

Address: _______________________________________________________________________

City:  _________         ZIP Code:   ___________             Country:  _________________________

Tel: __________________             Fax:  __________________      Email: ___________________

 

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