Payment of the IASS

Membership form and Payment

FORM FOR MEMBERSHIP (Data to be sent to Secretariat)

CATEGORY MEMBERSHIP

Individual 75 Euros	Collective 375 Euros	Student 10 Euros

Category:	......................................
Name:	.................................................. .......................................
Title :	.................................................. .......................................
Affiliation :	.................................................. .......................................
Address :	.................................................. ........................................ ........................................... ..............................................
Telephone :	................................................
Telefax :	................................................
e-Mail :	................................................

WAY OF PAYMENT

PAYMENT WITH VISA OR MASTERCARD

VISA ...	MASTERCARD ...

CARD No:

EXPIRATION DATE :

CARD HOLDER :

AMOUNT :

SIGNATURE :

OTHER WAY OF PAYMENT

Bank Trasfer to:

Banco Guipuzcoano, C/Serrano, 67, 28001 Madrid. Spain
Account nº : 0042 0030 67 0110149859
IBAN CODE: ES62 0042 0030 6701 1014 9859
BIC (Bank Identifier Code): BGUIES

IASS Secretariat
CEDEX: Laboratorio Central de Estructuras y Materiales
Alfonso XII, 3 .--. 28014 Madrid, Spain
Tel: 34-91-335 7409 .-. Fax: 34-91-335 7422
Mail: iass@cedex.es

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