REGISTRATION FORM

To register the 5th. International Congress on Arsenic in the Environment you must:

1) Fill the pre-registration form 
(*) Required field.

Prefix

*  

First name

*  

Last name

*  

Position

*  

Company or Institution address

*  

e-mail

*  

Phone number

*  

Address

*  
City *  
Country *  
Invoice consigned to *  
Comments    
Events    
Welcome Cocktail    
Congress Dinner    
Congress Trip    
 
2) Make payment with any of the means described below. After payment, send a copy of the constancy to help@as2014.com.ar

1) For city residents outside Argentina: TRANSFER
Account number: 25 604 40609
Holder: Fundacion Jose A. Balseiro, Inc
International Bank Code (IBAN): Non
Code Swift o ABA: BOFAUS3N
Bank: Bank of America
Address Bank: 4213 First Street, 94551 Livermore, CA, USA
Bank Telephone: (925) 833 9588
Routing Number: 121000358

2) For city residents in Argentina: TRANSFER
Account number:0056973
CUIT number: 000000030626000602
CBU number: 072003282000000569736
Holder: FUNDACION JOSE A BALSEIRO

3) Payment online

Registration

Before Nov. 20th 2013

Already sent abstract

Regular participants

400

350

Argentine participants

250

200

Students

200

150

Accompanying persons

100

Dinner (optional)

50

Short course (11 May 2014)

100