University of California,
1200 University Avenue
(92507-4596)
Riverside, California • USA

 
Speakers Registration Form
   
 
Main Speaker
fields marked
with * are required
* Last Name
* Name
Mailing Address
Zip Code
* City
* State/Province
* Country
* Telephone number
(Please include country & area codes)
Cell phone
* E-mail address
• How did you first hear
about this Conference?

• Have you ever attended any
of our seminars/events before?
If so, which one/s?
 
     
   
 

Co-Speaker

Last Name
Name
Mailing Address
Zip Code
City
State/Province
Country
* Telephone number
(Please include country & area codes)
Cell phone
E-mail address
• How did you first hear
about this Conference?

• Have you ever attended any
of our seminars/events before?
If so, which one/s?
 
     
   
 
Institution
Organization
Telephone number
E-mail
Position/Title


Please, submit picture and institutional logo upon receipt of the acceptance letter.

 
     
   
 

Registration
Fees

Speakers Fee:
U$S 200
 
  The registration fee is non refundable.
 
 
   
 
Payment
Options
 
PAYMENTS FROM THE USA

Checks
Checks must be payable in U.S. dollars (drawn on a U.S. bank) to LAURA LEWIN. Institutional checks should come together with a list of participants. Mail your checks to:

Laura Lewin
25 SE 12 av.
Fort Lauderdale- FL 33301 USA

 

Credit cards (Via Paypal)

 


US WIRE TRANSFERS (For organizations in the USA)
Receiver Bank Name: BankAtlantic
Fort Lauderdale, FL
Receiver Bank ABA#: 2670-8376-3
Beneficiary Acct #.: 11-0513999-6
Beneficiary name: Laura Esther Lewin

 
PAYMENTS FROM ARGENTINA


by bank transfer / deposit at Banco de Galicia
Savings Account (Caja de Ahorros en pesos) beneficiary: Miguel Atencio
Number 4899626-1246-1
CBU: 0070246330004899626113
DNI:18.730.961
CUIT: 20-18730961-2


by bank transfer / deposit at Banco Francés
Savings Account (Caja de Ahorros en pesos) beneficiary: Miguel Atencio
Number 237014658 6
CBU: 01702370- 40000001465860
DNI: 18.730.961
CUIT: 20-18730961-2

Giros Postales: Payable to Miguel Angel Atencio Castel. Solicitar que la oficina de pago sea la sucursal de Olivos, Buenos Aires y enviar un sobre con el giro postal, aclarando remitente, a Fray Luis Beltrán 2439, (1640) Martinez, Buenos Aires, Argentina.

 
PAYMENTS FROM URUGUAY

 

Banco Credit Uruguay - Savings account in dollars (Caja de Ahorro en dólares N° 27-23209 (beneficiary: Marcelo Caig).
Please add U$S 5 to the transaction for processing charges.

 
PAYMENTS FROM OTHER COUNTRIES

  WESTERN UNION
 

Please send registration fee through Western Union, payable to Miguel Angel Atencio Castel (Use full name please). Fax your Western Union guide to 5411-4794-9002

 

INTERNATIONAL WIRE TRANSFERS (For organizations outside the USA)
US DOLLAR ONLY!
Receiver Bank Name: BankAtlantic
Fort Lauderdale, FL

SWIFT: BKATUS3F
Receiving Bank ABA#: 2670-8376-3
Beneficiary Acct. #: 11-0513999-6

Beneficiary name: Laura Esther Lewin
Please add U$S 10 to the operation for administrative charges

 

INTERNATIONAL FOREIGN CURRENCY TRANSFERS (in Euros or GBP)
Send to: bank of Ireland
Treasury and International Banking
Colvill House, Talbot Street
Dublin 1, Ireland

SWIFT: BOFIIE2D
Sort Code: 90-13-94
In favour of (For EUROS wires) Account # 48477003 of Foreign Currency Exchange Corp.
Or (For FBP wires) Account # 48477001 of Foreign Currency Exchange Corp.

Reference: BankAtlantic
Fort Lauderdale, FL

For further credit to: Laura Esther Lewin, Account number # 11-0513999-6
Please add U$S 25 to the operation for administrative charges

 
  Submitting this form means the participant has read and acknowledges the conference policies and regulations.