(Credit Card in South African Rand)
Credit Card
MasterCard
Visa
Card No.
Last three digits on the back of credit card (CCV) ______________________________
Expiry Date: _____________________________________________________________
Card Holder’s
Name__________________________________________________________________
I, _____________________ hereby give UKZN Conferencing Services the permission to Debit
my credit card account with the amount of R_______________________ as payment for the
ECO 2012 conference.
Signature_____________________________________________________________________
UKZN Conferencing Services
Room 119 Innovation Centre, Gate 9 Howard College, University of KwaZulu-Natal
Tel: +27 31 260 1604/2709; Fax +27 31 260 1606
Email: eco2012@ukzn.ac.za