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					                                CREDIT CARD PAYMENT FORM

     «New Technologies for Probing the Diversity of Brown Dwarfs and
                              Exoplanets»
   Shanghai Astronomical Observatory, Shanghai, China, July 19–24,2009

                    Please fax this form to +86 21 64648765
             (fax machine is secure and not accessable to a third party)

Name of Participant:……………………………………………………….............

Please charge to the following credit card:

Type of Credit Card (circle one)              Visa / MasterCard /EUROCARD/

Name of Card Holder (as on Card) : ………………...………….......…...........................

                Billing address of card: .................................................................................

                                                 ......................………………………………………….

                Credit Card Number: ...............………………………………………………….

  Expiration Date (Month/Year) ....................................…………………………………….

1. I hold this credit card.

2. I hereby authorize the organizers of New Technologies for Probing the Diversity of
   Brown Dwarfs and Exoplanets to charge the symposium registration fee of 300/350
   (150/200 for student)USD to the credit card above, if I register before/after May 1st,
   2009.

3. My credit card will be charged in one week after I send this form.

4. If I cancel my registration before May 1st, 2009, there will be handling fee of 20 USD
   deducted from refund; If I cancel my registration after May 1st, 2009, there will be no
   refund of the registration fee;

5. Student : yes or no? ........................................

I agree with the above terms.

Signature:……………………………                                          Date: …………………………………
(mandatory)

				
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