Information about http://www.ifla.org/V/pr/CreditCardPaymentForm.pdf
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Tags: american express, credit card payment, creditcard, cvc, e mail, hague netherlands, ifla, mastercard eurocard, membership code, mr ms, netherlands tel, organization mailing address, security code, visa american express,Pages: 1
Language: english
Created: Fri May 23 12:33:51 2008
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IFLA Headquarters
P.O. Box 95312
2509 CH THE HAGUE
Netherlands
Tel: *31 (0)70-3140884
Fax: *31 (0)70-3834827
CREDIT CARD PAYMENT FORM E-mail: ifla@ifla.org
First name:
Family Name: Mr/Ms
Organization:
Mailing Address:
EMAIL: ________________________________________ please write as clearly as possible
Regarding: IFLA Publications
IFLA Membership (membership code: - )
Other
Charge my Creditcard for the amount of ............................................
Visa American Express MasterCard / Eurocard
Number : ........................................................................ Expiry Date : .................................
Card in the Name of : ...........................................................................................................
CVC II / Security code: ............................................
(see back of creditcard last 3 digits/American Express 4 digits)
Date: Signature: