1st Portuguese Conference on “Workplace Bullying”

“Increasing awareness of Workplace Bullying: Concepts, Research and solutions”

29-30 Novembro 2007, Lisbon, Portugal


Fill the form in capital letters and send it by fax or mail

Surname / First name
Institution and address
Zip Code / Country
Telephone / Fax
E-mail address

REGISTRATION FEE

Euro/Participant / Total
Participant
(with Presentation) / Until September, 30, 2007
After September, 30, 2007 / 100
125
Attending Participants
(without Presentation) / Until September, 30, 2007
After September, 30, 2007 / 150
175
Student / Until September, 30, 2007
After September, 30, 2007 / 50
75
TOTAL EUROS

Do you intend to receive an invoice ? Yes No . Name:______

VAT Number: ______

PAYMENT CONDITIONS[1]

A Payment of _____ Euros has been transferred to SOCIUS – Research Centre in Economic Sociology of Organisations
Bank: Caixa Geral de Depósitos Adress: CGD/ ISEG, Rua do Quelhas, 6 1249-078 Lisboa
IBAN: PT50 0035 0371 0000 2052 3307 8 (International payments)
BIC/SWIFT: CGDIPTPL
Account nº: 0371002052330 NIB: 0035 0371 00002052330 78 (Domestic payments)
Please, mark “1st Conference – WB” and the participant name on the remittance. (copy of the transfer should be delivered to secretariat through fax or e-mail otherwise payment will not be considered)
I enclose a check of _____ EUROS, made payable to SOCIUS – ISEG / UTL
Bank: ______Check nr: ______
Please charge my credit card: Visa Mastercard Eurocard
Credit Card nr______Expiration date ______/______Amount in Euros______
Credit Card Verification Code [2] |____|____|____|____|
Billing Address: ______
Cardholder Signature (as in the card) ______
Date ______/______/______

Date: ______

Signature: ______

PLEASE RETURN THIS FORM AND PAYMENT TO

SOCIUS – Centro de Investigação em Sociologia Económica

Rua. Miguel Lùpi, 20, 2º Piso, 1249– 078 Lisboa, Portugal Tel: +351 21 395 17 87 Fax: 21 395 17 83

For more information contact the secretariat at – Web-Page: http://pascal.iseg.utl.pt/~socius/home.html

[1] Please note that all currency exchange charges or bank collection fees are the responsibility of the participant.

[2] Credit Card Verification Code: for Visa and MasterCard use the last 3 digits in the signature panel on the back of the card; for American Express use the additional 4 digits printed to the left or right above the card number on the front of the card.