Thursday 15 June 2017
METROPOLITAN HOTEL ATHENS
R E G I S T R ATI ON FOR M
Please fill the present Registration Form
and return it by fax or e-mail to the Event Secretariat:
ALICE TRAVEL & CONGRESS
3, Lekka Street, 105 63, Athens - Greece
Tel.: +30 210 3235185
Fax: +30 210 3230423
E-mail: [email protected]
URL: http://www.hsa.gr/pireas-2017.html
SURNAME:
NAME:
TITLE:
CITY:
POSTAL ADDRESS:
POSTCODE:
COUNTRY:
TEL (Please include country code):
MOBILE:
FAX:
E-Mail:
REGISTRATION FEES
Registration type
By 09/06/2017 and on - site
• FORUM
30
Registration Fee includes:
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✓
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Attendance of the Program
Congress Material (Forum’s Folder, Program, badge)
Cof fee Break
Light Lunch
Mineral water & soft drinks during the Light Lunch
Vat 24%
CANCELLATION POLICY
✪ Registration fees are non refundable
PAYMENT CONDITIONS
• By bank remittance to :
ALPHA BANK S.A.
IBAN: GR5701401140114002320002999
BIC: CRBAGRAA
HOLDER OF THE ACCOUNT: AFOI ANTONIOU OIKONOMOU & SIA EE – ALICE TRAVEL
Please send us by fax (+30 210 3230423) the bank transfer receipt by
mentioning the Event and participant’s name.
• By Credit Card
All major credit cards are accepted. Please complete the following information
and return the following statement duly signed (by fax or e-mail) in order to charge
the Credit Card with the relevant amount.
Please note that it is very important to write the last 3 digits found
on the rear side of the credit card.
I authorize ALICE TRAVEL to debit my Credit Card for the amount of _________ euro
No. Card:
Expiry date: __ /__ / __
CCV Code (3 last digits on the back of your card):
Cardholder’s Name (as displayed on the card)
Visa
Diners
American Express
Date: __ /__ / __
Mastercard
Signature:
INVOICING DETAILS
In case you need an invoice instead of a receipt, please complete the following details:
COMPANY NAME :
CONTACT PERSON :
PROFESSION :
POSTAL ADDRESS:
CITY :
TEL (please include country code):
POSTCODE :
Fax :
COUNTRY :
E-mail :
VAT No:
Tax Authority – DOY (only for Greek companies):
IMPORTANT NOTE: All the aforementioned costs are payable in full without deduction of
any bank charges. All banks surcharges are payable by the participant.
Date:
Signature: