Event Organizer
 
Participant Data
Compumag 2007 Secretariat
Institut of Electrical Machines
Dr. Dirk van Riesen
Schinkelstr. 4
52056 Aachen
Germany
Fax (national): 0241-8092270
Fax (international): +49-241-8092270
 
user ID (on Compumag server, e.g. 123): .....................
Name: ...................................................................
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Adress: .................................................................
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Country: ................................................................
Payment Form for 'the 16th International Conference on the Computation of Electromagnetic Fields'
Qty. Event / Product   Unit Price Total Price
............................................................. ............................................................. ............................................................. ............................................................. .............................................................   € 
€ 
Total € 
 
 
 
Remark of Participant
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Payment Information
Type of credit card:
 Visa
 Mastercard
Credit card holder:
Credit card number:
     
Card validation code:
 
Valid until:

Debit Agreement
I hereby authorize the organizers of 'Compumag 2007' to charge my credit card referenced above in the total amount of   €................

Date/Signature: ________________ , _______________________________________