Boleta De Inscripcion Para El

REGISTRATION FORM FOR

I INTERNATIONAL FORUM ON COOPERATIVE LAW

II CONTINENTAL CONGRESS ON CO-OPERATIVE LAW

Montevideo, November 16 - 18, 2016

Full Name and Title:

Sex: Female () Male ()

Type of participation: Delegate () Observer ()

Degree in Law:

Will present paper: Yes () No ()

If yes, specify topic:

Title of the paper:

Organization or entity:

Job Title:

Address:

City:

ZIP or postal code:

Country:

Phone number: Fax:

E-mail address:

Registration entitles you to:

• Congress briefcase and documentation
• Refreshments and lunchs during the two days of the Forum-Congress
• Closing Dinner
• Special rate at the event's hotel

Registration

Please fill out the registration form and send it to the office of Cooperatives of the Americas to the following email:

You can pay the registration fee using the following payment methods:

Cash

Directly at the offices of Cooperatives of the Americas in San José de Costa Rica (Phone number: 506 -2296 -0981)or upon arrival at the Congress. Keep in mind that if you choose to pay at the Congress, preparation of the materials can lead to delays that can be avoided by paying in advance.

Bank Transfer

Banco Nacional de Costa Rica, Oficinas Centrales, San José, Costa Rica
Cuenta en dólares No. 605647-7 of the Alianza Cooperativa Internacional,
Swift code: BNCRCRSJ. Bank Address: Avenida 3 y 5 calle 4; specify your name in the reason for payment.

Bank transfer costs must be borne by registrants. Therefore, the exact amount to be transferred shall be the sum total of the transfer plus charges applied by your intermediary bank, local costs and US$ 15 for bank intermediation costs charged by the Banco Nacional de Costa Rica when the money is received.

To facilitate tracking of your payment, once you have made the transfer, please send us an e-mail with the details and a scanned image of the receipt to the following address:

Payment by VISA or MASTER CARD

Download, print and fill out with block letters the credit card payment form and send us a scanned image to the e-mail address Download form

This option has an additional charge of 5%, so the amount payable in the form should be the registration fee multiplied by 1.05.

Money Gram Transfer

For making the transfer you will need to provide the recipient's name and identity document number.

The data to be provided is the following: Carlos Alberto Quintero, Número de Residencia 159100056413. You must also specify that the transfer is made to San José de Costa Rica.

MoneyGram will provide a reference number for your transfer. Please send us this number by e-mail by writing to , including the amount being forwarded and the data of the ID document and name of the individual who made the transfer (the person that signed the remittance form). The use of this option involves no extra charge on our part, but the fee charged by MoneyGram must be paid by the sender. To facilitate tracking of your payment, once you have made the transfer, please send us an e-mail with the details and a scanned image of the receipt to the following address:

PAYPAL Payments:

Paypal is the safest and easiest way to make online payments without disclosing financial information to a third party. You only need to provide the following e-mail address:

Paypal charges a fee of 5.4% + $ 0.30 per transaction, so the total amount to be paid should include the registration fee plus the fee indicated above.