the amount ......................................................................... for :
Payment
form with credit card
Please print it and send it by ground mail or by fax to:
Società Meteorologica Italiana
Castello Borello, 10053 Bussoleno TO, Italy - FAX +39
0122 641914
Please, charge on my
credit card
the amount .........................................................................
for :
Annual membership to Società Meteorologica Italiana :
Euro 42,00
Purchasing of Nimbus Collection and Annual membership
to Società Meteorologica Italiana
:
Euro 191,00
Purchasing of Nimbus Collection : Euro 175,00
NAME………....…………...............……..SURNAME……………….........................……...............
ADDRESS………....……………………………………........................................……...……..........
POSTAL CODE………….……..TOWN……....….............................................................................
STATE/PROV…............................COUNTRY.....................................................................................
TEL……....…...............................………………...........…..EMAIL…….....……..................................
CARD NUM. |_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_| EXPIRATION DATE……………....................
VISA
MASTERCARD
EUROCARD
DATE .......................................................... SIGNATURE .........................................................
