registration form page 2/2
Participant:

Last name:  _______________________________________________   Mr/Ms

First name: _______________________________________________________

Total of fees: Write here the fees included in your payment transfering the proper information from the first page, and calculate the total. Workshop before May 5 after May 5 general 380 EUROS 430 EUROS EUROS _______ student 200 EUROS 250 EUROS (Proof of student statusi is required) Accommodation EUROS _______ Extra banquet tickets: _____ X 60 EUROS EUROS _______ ------------------------------------------------------------------- Total: EUROS _______ Payment should be net of all bank charges. Unfortunately we are not able to accept personal, company or Euro cheques. Please fill in the appropriate form of payment, a or b: a) The total payment of ________ EUROS has been transferred to the bank account of Eventra Ltd. Bankers: Merita Bank, Helsinki, Finland. Account number: 127930-509345. SWIFT address: MRITFIHH. b) Please charge the total payment of _________ EUROS from my credit card (circle appropriate): VISA / Mastercard / Eurocard Card number ________________________ Expiry date _______________ Date ______________________ Signature_______________________________