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INDIVIDUAL REGISTRATION FORM
Please send this form, filled out, together with a copy of the receipt of the form of payment, as soon as possible to the Secretariat of the Event, either by fax or e-mail: Secretariat, International Week of Distance Education, ABED-Brazilian Association for Distance Education, Avenida Lúcio Martins Rodrigues, Trav. 4, Bloco 18, Cidade Universitária, 05508-900 São Paulo, S.P., Brazil. Telephones: +55-11-816-8168 and 818-4924. Fax: +55-11-816-8168 and 815-3083. E-mail: abed@edu.usp.br METHOS OF PAYAMENT: Money Order/Bank Draft. Please
make it payable to: Credit Card ( VISA / AMEX ) Card Number:________________________________ Card Holder's Name:___________________________________ Expire Date:__________________________ Card Holder's Signature:________________________________
The values will be converted in Reais ( Brazilian money) in accordance with the quotation of exchange, in the day of payament. CANCELLATION: A 75% refund will be issued for wittes cancellation received before 14 July 2000. There will be no refunds after 14 july 2000 |
Dates Values in for Non-Members Members Until 30 April R$ 170 R$ 120 Until 15 Jun R$ 180 R$ 130 After 15 June R$ 190 R$ 140
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