Credit Card Payment
DATE: ___________________ FAX:
+30 210 6682708
ATTENTION: Ms Lilian Spilioti, AIT Bursar FROM: Tel: SUBJECT: PAGES: ________________________ ________________________ ICTON2008 Registration Fee Payment 1 Number of Participations Full Registration Fee Invited Speaker & IEEE Members Registration Fee Student Fee Accompanying Person 500,00 € 450,00 € 350,00 € 100,00 € Affiliation: ______________________
Total Number of Participants: __________ Participants’ Names: 1. _____________________________ 2. _____________________________ 3. _____________________________ 4. _____________________________ 5. _____________________________ 6. _____________________________ Total Amount to be charged: € _____ , ___ Credit Cards (please check
accordingly):
Name on Card: __ . ____________________ Number: _______ _______ _______ ______ Expiry Date: ______ / ______ (mm/yy)