Exhibitors' Form

Please complete and sign this form. Send it by postal mail or fax to:

Carlos Delgado Kloos. General Chair
Universidad Carlos III de Madrid. C/ Butarque 15, E-28911 Leganés (Madrid) Spain
Fax: (+34-1) 624-9430. E-mail: chdl97@it.uc3m.es
Company: ......................................................................................................................................
Contact person: ......................................................................................................................................
Address: ......................................................................................................................................
Postal code: .................... City: ..................................... Country: ...........................................
Phone: .................... Fax: ..................................... E-mail: ...........................................

Exhibition price (in Pesetas)   # booths
Booth (2x3 m2) 126.000  
TOTAL FEE  

Methods of payment (all payments in Spanish Pesetas):

eurocheque (must accompany registration form) in Pesetas, payable to Universidad Carlos III de Madrid.
cheque (must accompany registration form) in Pesetas, drawn to a Spanish bank, payable to Universidad Carlos III de Madrid (fees to be charged to the issuer of the cheque).
bank transfer to:
Univ. Carlos III de Madrid, Ref. 442. Account: 2110064856; Bank code: 0049-0581-19. Bank Name: Banco Central Hispano. Address: Juan de la Cierva 38, E-28911 Getafe/Madrid
Fees to be charged to the participant. Please indicate participant's name and affiliation in the transfer!
credit card:
Mastercard/Eurocard Visa
Card holder's name: ..........................................................................................
Credit card number: ..........................................................................................
Expiration date: ..........................................................................................
Card holder's signature: ..........................................................................................
Cancellation by postal mail or fax is possible if received by April 1, 1997; 75% of the payment will be refunded. After that date, no refunds will be made.
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Date Signature