ORGANISATIONAL MEMBERSHIP FORM Organisation Name: Speciality: Delegate’s Name: Mail Address: Phone: e-mail: Fax: Web page: Amount in Euro: For the Year (Membership due is minimum 250 Euros) Payment by VISA or MasterCard Card Holders Name: Card Type: VISA: MASTERCARD: Card Number: Expiration Date: / Card Holder’s Signature: Date: YES NO Automatic Renewal of Membership only for payment with credit cards Please fill out the form, sign it and fax it to Central Office (Fax: +90 212 203 1127) or scan it or convert the doc file to pdf file and send it as e-mail attachment to ansal@boun.edu.tr. Please mail the original signed form to: Prof. Atilla Ansal, President of EAEE , Kandilli Observatory and Earthquake Research Institute Çengelköy, For the payment by bank transfer the account name and related information: Avrupa Deprem Mühendisliği Birliği (European Association for Earthquake Engineering) Garanti Bank, Bogazici University Branch, Istanbul Campus, Branch No: 303, Account No. 9090519 SWIFT Code: TGBATRIS – IBAN No: TR33 0006 2000 3030 0009 0905 19
ORGANISATIONAL MEMBERSHIP FORM Organisation Name: Speciality: Delegate’s Name: Mail Address: Phone: e-mail: Fax: Web page: Amount in Euro: For the Year (Membership due is minimum 250 Euros) Payment by VISA or MasterCard Card Holders Name: Card Type: VISA: MASTERCARD: Card Number: Expiration Date: / Card Holder’s Signature: Date: Automatic Renewal of Membership only for payment with credit cards YES NO Please fill out the form, sign it and fax it to Central Office (Fax: +90 212 203 1127) or scan it or convert the doc file to pdf file and send it as e-mail attachment to ansal@boun.edu.tr. Please mail the original signed form to: Prof. Atilla Ansal, President of EAEE , Kandilli Observatory and Earthquake Research Institute Çengelköy, For the payment by bank transfer the account name and related information: Avrupa Deprem Mühendisliği Birliği (European Association for Earthquake Engineering) Garanti Bank, Bogazici University Branch, Istanbul Campus, Branch No: 303, Account No. 9090519 SWIFT – Code: TGBATRIS IBAN No: TR33 0006 2000 3030 0009 0905 19
OrganisationalMembershipForm.docx