Name:

Organization (if any):

Street address:

City and postal/ zip code: -

Country

Contact: Phone Fax

e-mail

The registration fee is &euro 200.00 + 20%VAT (totalling &euro 240.00) for payments received until May 15, 2009 or
&euro 250.00 + 20% VAT (totalling &euro 300.00) for payments received after May 15, 2009

Accepted payment methods: Cheque
Bank Transfer
Visa or Mastercard
American Express

Bank transfers

*must be free of bank charges to the organizer

• Transfers within Portugal
  NIB: 001803650020001058222
• Transfers from abroad
  IBAN: PT 50 001803650020001058222
  SWIFT code: TOTAPTPL
  (Santander Bank Portugal - Largo Frei Heitor Pinto, 7-A/B - P-1700-204 Lisbon
  Account holder: FUNDCIC

To insure traceability of payments, please mention "XIV INTERNATIONAL
CONFERENCE ON NONLINEAR ELASTICITY IN MATERIALS" and your last name
in the transfer information and attach proof of transfer to the registration form.

Cheque payments

(only for participants having a bank account in Portugal)

Cheque number

Name of bank

In the amount of &euro payable to FUNDCIC

SEND TO:
Laboratório Nacional de Engenharia Civil
Apoio à Organização de Reuniões(XIV ICNEM)
Av. Brasil 101
P-1700-066 LISBOA
Portugal

Credit card payments

Visa or Mastercard

Please indicate:

Name of Cardholder

Credit card number

Expiration date ( m m / y y) /

Safety code (last 3 digits on the signature
area on the back of your card)

Date and authorised signature

American Express

Please indicate:

Name of Cardholder

Address of Cardholder

Credit card number

Expiration date ( m m / y y) /

Safety code (4 digits on the front of
your card above the card number)

Date and authorised signature

If necessary, provide the name and VAT to appear
on the invoice/receipt
Name VAT number

Notes: