Name (Last, First)
Organization
Street Address
City
State
Country
Zip or Postal Code
Telephone
Fax
E-Mail Address
Fees (in Euros):
Full package*, including all meals, banquet and field trip Euro 150
Registration only (meals, banquet and field trip NOT included) Euro 100
Total
*Includes lunches or box lunches on July 14, 15 and 16, banquet dinner at The Prado, Balboa Park (rated among the best restaurants in Southern California), field trip to “Mystical and Theosophical Southern California”
.
Method of Payment
a) Credit Card
Type of Card VISA MasterCard EuroCard
Here are the details of my credit card for immediate on-line registration:
Name on Card (print)
Number
Expiration Date
Birthdate (mandatory: month-day-year)
Signature (not needed for online registration):_____________________________
I will mail the details of my card with a printed and signed copy of this form
b) I want to register now and am sending a printed and signed copy of this form with details of my bank draft ___
If you do not register online, please fax or mail registration forms (including details of your credit card) to:
CESNUR
Via Confienza 19
10121 Torino, Italy
Fax: +39-011-541905
If you select option (b) please mail or fax forms to CESNUR, and send bank drafts to CESNUR PIEMONTE as follows
Name of bank: Deutsche Bank, Via Arcivescovado 7, 10121 Torino, Italy
Bank codes:
Account number: 33719
ABI: 3104
CAB: 01000
Students of the San Diego Area Universities
For reduced rates (registrations only, no meals, field trip or banquet included) please contact Rebecca Moore at remoore@mail.sdsu.edu. If you want your registrations to include meals, banquet and field trip you should register online through this page
