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Credit Card:
Card
holder's name
VISA
MasterCard
Card number
Expiration date Amount
Signature
(required)
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Bank transfer to*:
"Congressos i Cursos CRM"
Bank's name: Caixa Catalunya
Bank's address: Pl. Cívica, Campus UAB
08193 Bellaterra
Spain
IBAN: ES37 2013 0692 8502 0206 2742
Swift code: CESCESBBXXX
* IMPORTANT: Please make sure that the
administrative costs originated by the bank transfer are charged to the sender's
account. CRM is to receive the full registration fee, free or charges.
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Nominative
Cheque to: "Congressos i Cursos CRM"
Cheque no.
Issuing
Bank Amount
Deadline for
General Registration
and Payment: December 10, 2006
Deadline for Room booking fee Payment (for those receiving a lodging grant):
Will be announced individually together with the ressolution to
the application.
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Please, fill in, print, sign and fax this document to the number: +34-93 581 22
02, together with the
receipt or proof of
payment (in case of bank transfer).
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