To attend
XIV APPLIED ECONOMICS MEETING
,
please send this form:
XIV Encuentro de Economía Aplicada
Fundación Economía Aragonesa
C/ Costa, nº 9, entresuelo derecha. 50001 Zaragoza
Tel. 976 46 86 50 / Fax 976 21 76 42
E-mail:
eea@unizar.es
SURNAME
NAME
ADDRESS
UNIVERSITY OR RESEARCH CENTRE
POSTAL CODE
CITY
HOME TEL.
WORK TEL.
FAX
E-MAIL
NIF
-
I WISH TO ATTEND THE CONFERENCE AND
I PRESENT A PAPER
I DO NOT PRESENT A PAPER
ARE YOU WILLING TO PRESENT THE PAPER
TO THE YOUNG RESEARCHERS ALdE PRIZE 2010?
YES
NO
conditions
REGISTRATION FEES
BEFORE THE 16th MAY
CONCEPT
CONDITIONS OF ASSISTANT
PAYMENT OF THE REGISTRATION
MEETING REGISTRATION
NO ALdE MEMBERS
150,00 €
MEETING REGISTRATION
ALdE MEMBERS
125,00 €
PAYMENT ALDE 2011 + MEETING REGISTRATION
ALdE MEMBERS NUMERARIO
205,00 €
PAYMENT ALDE 2011 + MEETING REGISTRATION
ALdE MEMBERS NO NUMERARIO
165,00 €
AFTER THE 16th MAY
CONCEPT
CONDITIONS OF ASSISTANT
PAYMENT OF THE REGISTRATION
MEETING REGISTRATION
NO ALdE MEMBERS
200,00 €
MEETING REGISTRATION
ALdE MEMBERS
175,00 €
PAYMENT ALDE 2011 + MEETING REGISTRATION
ALdE MEMBERS NUMERARIO
255,00 €
PAYMENT ALDE 2011 + MEETING REGISTRATION
ALdE MEMBERS NO NUMERARIO
215,00 €
PAYMENT METHOD
CHARGE TO MY CARD
VISA
EUROCARD
MAESTRO
MASTERCARD
I AUTORIZE THE FUNDACIÓN ECONOMÍA ARAGONESA TO CHARGE A TOTAL OF
€
TO MY CARD NUMBER
EXPIRY DATE
ENERO
FEBRERO
MARZO
ABRIL
MAYO
JUNIO
JULIO
AGOSTO
SEPTIEMBRE
OCTUBRE
NOVIEMBRE
DICIEMBRE
AND CARD HOLDER´S NAME
NIF
-
DATE
ENERO
FEBRERO
MARZO
ABRIL
MAYO
JUNIO
JULIO
AGOSTO
SEPTIEMBRE
OCTUBRE
NOVIEMBRE
DICIEMBRE
20
SIGNATURE
BANK
TRANSFER
TO XIV APPLIED ECONOMICS MEETING TO THE BANK: IBERCAJA; ACOUNT Nº: 2085-0103-97-03-317518-65; ; IBAN ACOUNT Nº ES33 2085 0103 9703 3175 1865
OF A TOTAL OF
€
enclosing a proof of payment by post or fax
CHEQUE
TO THE XIV APPLIED ECONOMICS MEETING
FROM THE BANK
NUMBER
OF A TOTAL OF
€
GENERAL
CONDITIONS
*
No form will be admitted if it is not correctly filled in. Send only one form per person.
*
For payments by credit card, you will have to send the signed form.
*
For payments by transfer, it is necessary to send the receipt of the transfer by POST or FAX.
COMMENTS
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