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: ICNBS Egypt 2013 25-27 October 2013
Registration Form
Please fill out then email to HYPERLINK "mailto:nakaa.nanotechnology.network@gmail.com"nakaa.nanotechnology.network@gmail.com and HYPERLINK "mailto:ises.nano@gmail.com"ises.nano@gmail.com
*Confirmation of Registration
The confirmation of registration and receipt of payment will only be sent when both the registration form and payment in full are received. The confirmation will be sent to the participant be e-mail
Participant information:
Title:
First and middle Name:
Last Name:
Affiliation:
Job Title:
Address:
Postal Code:
City:
Country:
Tel.: + ( )
Fax: + ( )
E-mail:
Web: HYPERLINK "http://www"http://www.
Method of Fees payment: Fees are to be paid to:
Account name: ISES Egypt
Account number: 24704
SWIFT: FIEG EG CX DOK
Bank name: Faisal Islamic bank of Egypt
Bank branch: Dokkii branch
Bank address: 9 Adel Rostom street from Nile street - Dokkii
You can pay the fees in any other branch but you need to provide the above bank details during payment so that the fees will be directed to the bank branch listed above so you have to tell the bank employee that you need to direct the fees to the above listed bank : Dokkii branch bank
* *You will receive from the bank a payment confirmation paper. Please scan it and send it to HYPERLINK "mailto:ises.nano@gmail.com"ises.nano@gmail.com toconfirm your registration and payment.
Signature ,Date.
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