This document is a registration form for a forum being held in Villa Mercedes, San Luis, Argentina. It requests the attendee's personal details like name, identification number, address, email, phone number, province, and country. It also asks for their place of employment or organization, activity, how they heard about the forum, and what sessions they are interested in attending.

1. BOLETIN DE INSCRIPCION
VILLA MERCEDES. SAN LUIS. REPUBLICA ARGENTINA
DATOS PERSONALES
NOMBRE y APELLIDO_____________________________________________________
DNI:_________________/.- DOMICILIO_______________________________________
E-MAIL:_____________________________________________________/- CP:________
PROVINCIA:________________________/- PAIS:________________________________
TELEFONO:________________________/- CIUDAD _____________________________
EMPRESA-INSTITUCION-ORGANISMO AL QUE REPRESENTA: ________________
__________________________________________________________________________
ACTIVIDAD:______________________________________________________________
SUGERENCIAS:___________________________________________________________
__________________________________________________________________________
MEDIO POR EL QUE SE ENTERO DE ESTES II FORO:__________________________
CAPACITACION QUE LE GUSTARIA ASISTIR_________________________________

2. __________________________________________________________________________