ICMC 1997
CONFERENCE PAYMENT FORM

TOTAL from Conference Registration Form:	____________
TOTAL from Accommodation Request Form:	____________
TOTAL from Workshops Registration Form:	____________
TOTAL Charges:	____________

__ I have enclosed a personal check, bank draft or money order payable to ICHOGRAMMA

__ in Greek drachmas

__ in U.S. dollars,

__ Please charge the above fee to VISA, MASTERCARD or AMERICAN EXPRESS:


Card Number: _______________________________________________________

Expiration Date: _____________________________________________________

Cardholder's Name: __________________________________________________

Cardholder's Signature: _______________________________________________



PLEASE NOTE THAT WE CANNOT ACCEPT VISA CHARGES BY EMAIL, BECAUSE WE MUST HAVE A SIGNATURE. You must send the payment either by fax (+30-31-994769) or by regular mail.


We will accept payment in Greek drachmas or US Dollars ONLY.


Notification of cancellation must be received in writing by July 1, 1997. The cancellation will be considered valid upon your receipt of our answering letter verifying the receipt of your cancellation letter. An administration charge of 5.875 Greek Drachmas or $25.00 will be deducted for cancellations. No refunds will be given after July 1st, 1997.