Costs & Registration form
| PARTICIPANT
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| LAST NAMES
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FIRST NAME
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| ADDRESS
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| LOCATION
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ZIP CODE
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| PROVINCE/STATE
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COUNTRY
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FAX ( )
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E-MAIL
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PROFESSION / SPECIALIZED IN
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| PHONE ( )
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FAX ( ) E-MAIL
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| REGISTRATIONS
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REGISTRATIONS WILL BE RECEIVED BY THE CONGRESS SECRETARIAT UNTIL APRIL 18th, 2003. LATER REGISTRATIONS WILL BE RECEIVED DIRECTLY AT THE REGISTRATION DESKS AT THE SHERATON BUENOS AIRES HOTEL & CONVENTION CENTER DURING THE MEETING. ALL AMOUNTS ARE IN US DOLLARS AND V.A.T. IS NOT INCLUDED. (el arancel es en U$S o su equivalente en pesos al tipo de cambio vigente en el mecado libre de cambio (vendedor) al día del efectivo pago)
| Costs in US Dollars |
Before |
After |
On Site |
| |
Sept. 22th 2002 |
Sept. 22th 2002 |
(1 payment) |
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300 |
340 |
410 |
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OR 3 PAYMENTS
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100 |
115 |
N/A |
- REGISTRATION MEMBERS (membership fee up dated at March 24th, 2003)
|
270 |
310 |
370 |
| OR 3 PAYMENTS
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90 |
105 |
N/A |
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WAY OF PAYMENT
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| d CASH
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| d CHECK
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Bank
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Nº
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| d CARD
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Visa (VI) d
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MasterCard (MC) d
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American Express (AX) d
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| Number d d d d d d d d d d d d d d d d
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Holder
(Name as shown on card)
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| Exp. Date d d / d d
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Safety Code d d d d
VI / MC: last 3 digits on back of card / AX: Last 4 digits on upper front of card
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| SIGNATURE
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WRITE NAME
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DATE
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I HEREBY AUTHORIZE BAYFEM S.R.L. TO CHARGE THE ABOVE INDICATED AMOUNT TO MY CREDIT CARD
- Checks payable to: Bayfem S.R.L.
IV International Conference of the World Mediation Forum - 9 - 11 May, 2003 - Buenos Aires - Argentina
SECRETARIAT OF THE CONGRESS: Organización Bayfem
Av. Córdoba 2302 6º "K" - C1120AAS - Buenos Aires - Argentina - Phone (54 11) 4951-8139 Fax: 4952-4501 - email: wmf@bayfem.com.ar - www.bayfem.com.ar
- HOW TO REGISTER
Complete the Registration Form (including the Way of Payment Form) and mail it with your payment to WMF Congress Secretariat (Bayfem S.R.L. - Av. Córdoba 2302 6ºK - C1120AAS - Buenos Aires, Argentina). Make checks or money orders payable to Bayfem S.R.L. Registration forms can be also sent by fax or E-mail. Please check by phone if reception is not confirmed back to you within three working days. -EARLY-BIRD REGISTRATIONS
Must be received at the Congress Secretariat before April 18th 2003. -MEMBERS REGISTRATIONS
Members registrations are those made with membership fee up dated.
CANCELLATIONS
Cancellations should be notified in writing to the Congress Secretariat. Cancellations received up to April 18th 2003 will be reimbursed as follows: total amount minus U$S 50 (for administrative expenses). No reimbursements will be made after April 18th 2003.
Please send this form to: WMF Secretariat
Organización Bayfem National and International Congresses
Av. Córdoba 2302 6º "K" C1120AAS - Buenos Aires, Argentina
Phone (54-11) 4951-8139 Fax: (54-11) 4952-4501
E-mail: wmf@bayfem.com.ar - Web Site: www.bayfem.com.ar
Organización Bayfem is IAPCO and COCAL member.
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