5TH TAROT SUMMER SCHOOL

LAS NAVAS DEL MARQUÉS (ÁVILA, SPAIN)

JULY 6 – 10, 2009

First Name & Family Name______

Address ______

ZipCode______City______Country ______

Phone______Fax______E-mail______

Company / Institution ______

In compliance with the provisions in the Spanish Organic Law LO 15/99 of personal data protection, we inform that the personal information provided will be stored in a database controlled by the FG UCM. The fulfilment of the present form implies to authorize FG UCM to use the personal data facilitated for the mentioned purpose. If you wish to exercise your rights to access, rectify, cancel and oppose the treatment of your data, please contact our offices).

REGISTRATION

Early RegistrationLate Registration

(on or before May 15th, 2009)

Accommodation (double room, single use)850,00 €1000,00 €

Accommodation (double room, two participants), fee per participant 700,00 €825,00 €

Accommodation (triple room, three participants), fee per participant625,00 € 725,00 €

Important: In order to register as half or full grant, you must have been notified before by the organizing committee.

Half Grant - Accommodation (triple room, three participants), fee per participant300,00 €

Full Grant - Accommodation (triple room, three participants)

In the case of double/triple room, indicate the attendants with whom you would like to share the room:

If you are a PhD student and would like to give a 10-15 minutes presentation of your work, please, indicate title of the talk:

INVOICE DETAILS (in case you require an invoice)

Corporate name ______VAT number ______

Contact person ______

Address ______

ZipCode______City ______Country ______

Phone______Fax______E-mail______

METHODS OF PAYMENT

Remember to state your First name, Family name, and“TAROT 2009” on all payments.

By credit card. I the undersigned authorize FG UCM to charge to my credit card account the total amount stated

 VISA MasterCard

Card number __/__/__/__/__/__/__/__/__/__/__/__/__/__/__/__/Expiry date: ____/____CVC _____

Cardholder Name: ______

Place and Date: ______Signature: ______

By bank transfer to FG UCM. Caja Madrid. Account No. 2038 / 1735 / 91 / 6000402693 (SWIFT CAHMESMMXXX, IBAN ES90). Please indicate “free of charges for the receiver account”.

REGISTRATION CONFIRMATIONS

Oncewe check that the payment has arrived, the participant will receive the confirmation and registration details by e-mail. If you donot receive a confirmation within one week, please contact Manuel Núñez by e-mail at .

CANCELLATIONS & CHANGES

We accept changes in the name of the attendant (excluding half/full grants) without any additional cost. Cancellations, with a penalty of 20% for management costs, are allowed until June 20th. All cancellations must be sent in writing (fax or e-mail) in the same way the participant used to register.

Send this form (in case of bank transfer, include a copy) to:

Cristina Berbel, FGUCM

Fax: +34 91 394 6405

E-mail: