TSD 2008 Registration Fee
VISA
MASTERCARD/EUROCARD
Please print this Registration Form, sign it, and fax it to:
FAX: +420-549 491 820 Ing. Dagmar Janoušková
Conference participant's name:
Cardholder's name:
Card no.:
-
-
-
CVV:
(
Mandatory field
, 3 digits, you can find it at the reverse side of the card)
CVC:
(
Mandatory field
, 3 digits, you can find it at the reverse side of the card)
Expiration:
/
Amount to be payed:
CZK
Date:
Signature:
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