Booking Form
| Title: Prof/Dr/Mr/Mrs/Ms |
| Surname: | |
| First Name: | |
| Position: | |
| Organisation: | |
Address to which any correspondence should be sent:
Accommodation required for the nights of:
Payment:
Bank details:
| Bank: | Banco Central Hispano |
| Account number: | 0554-261-0148491 |
| Account name: | Porfirio Barroso Asenjo Angeles Nevado Llandres Ethicomp-96 |
Note:
Bank drafts and money orders should be made payable to 0554-261-0148491 ETHICOMP96
Send to
Porfirio Barroso (ETHICOMP96)
Clinica Puerta de Hierro,
San Martin de Porres 4,
28035 Madrid,
Spain
