2006
ECG SURVEY ON VEHICLE LOGISTICS
- ORDER FORM I wish to order ______ ECG Survey(s) for the price of € ___________ (incl. postage)
(ECG Members: € 50*; non-members: € 125*) Family Name: _ _______________________________________________________________________ Name: Company: Title: Address: Country: Tel: Fax: E-mail: VAT Number: _______________________________________________________________________ _______________________________________________________________________ _____________________________________________________________________ _______________________________________________________________________ ______________________________________________________________________ _______________________________________________________________________ _______________________________________________________________________ _______________________________________________________________________ _______________________________________________________________________
Zip Code + city: _______________________________________________________________________
□ Please debit my card (Visa-, Master-, Eurocard/Diners/ Am.Express) Cardholders name: _______________________________________________________ Card number: __________________________________________________________
Expiry date: _____________________________________________________________ Signature card holder: _____________________________________________________ □ I enclose a cheque made payable to ECG for the sum of € ________
Please complete this form and return by mail or fax to the following ECG address:
ECG, Diamant Building, Bd. Reyers 80, B-1030 Brussels, Fax: 00 32 2 706 82 81
* 6% VAT will be added for sales within Belgium and for EU companies without VAT number