CIB W99 Registration Form

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CONSTRUCTION PROJECT MANAGEMENT SYSTEMS:
THE CHALLENGE OF INTEGRATION
CIB W99 2003 International Symposium
REGISTRATION FORM version 4
Last name
First name
Title
Mr.
Mrs.
Dr.
Prof.
Other
Organisation/Company
Address
ZIP Code
City
Country
Phone
Fax
E-mail
Participation costs (FULL AMOUNT FREE OF CHARGES):
Special reduced fee for associated
institutions
US$150.00
R$ _______________
Includes proceedings, welcome reception, buffet lunches, coffee and conference dinner.
Accompanying person(s):
US$ 75.00
R$ _______________
Total Costs
R$_______________
If you are submitting a paper:
Title of paper:
Date of birth
(day/month/year)
/
/
Passport
Credit Card Authorization: please charge my payment of US$ _________to following VISA account number:
Name of cardholder
VISA Credit Card number
Expiration date
Date:
Signature:
Payment by bank order to our Brazilian Bank Account:
Bank: BANESPA – 033 - São Paulo Branch
SWIFT ADDRESS: BESPBRSPSP0
Beneficiary: PCC-EVENTOS
Account: 0658-43-007660-5
Alternative procedure: remit the proceeds by teletransmission to Bank correspondent : STANDARD
CHARTERED BANK - New York - Account: 544032961001 - Swift Address: SCBLUS33 - ABA: 026 FEDWIRE: 026002561 - for further credit to BANESPA
This form can be sent either by mail, fax or E-mail:
Escola Politécnica da USP – Coordenação de Eventos
Av. Prof. Luciano Gualberto, trav. 3, nº 380
05508-900 – São Paulo – SP - Brazil
FAX # 55 11 3091 5654 - http://www.pcc.usp.br/cib2003 - [email protected]
533577095
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