C O N F I R M A T I O N O F S U B M I S S I O N

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Thank you for submitting your Extended Abstract to the 8^th ICSHMO.

You will NOT be notified by e-Mail. For your convenience, you may this confirmation.
Up to March 15 th, you can update your extended abstract by returning to your on-line form at:
<http://$localSite/update/$repName>.

IMPORTANT: PUBLICATION OF THE EXTENDED ABSTRACT IS SUBJECT TO CONFIRMATION OF PAYMENT. TO AUTHORIZE THE PAYMENT BY CREDIT CARD, FILL OUT THE FORM BELLOW, PRINT IT, SIGN IT, AND FAX IT TO THE FOLLOWING NUMBER: +55 45 35219414, C/O NAIPI TOURISM OPERATOR LTDA.

FAX FOR EXTENDED ABSTRACT SUBMISSION PAYMENT

FROM

TO

Name:

Naipi Tourism Operator LTDA.

Phone Number:

+55 45 35219414.

City/Country:

Foz do Iguaçu / Brazil

E-mail:

naipi@naipi.com.br

Passport Number:
or Brazilian ID (RG)

Embratur: 08094-00-41-7

ABSTRACT ID: $repName
$title
$author

Credit
Card ?
Amount: U$ 50,00 (R$ 120,00)

Cardholder´s name as it appears on the card:

Signature of Cardholder

Card Number:
Security Code: What's Security Code?
Expiration Date :

Security Code
Unreadable

Important Notice:
- By signing this form you are authorizing the charge of the amount indicated above in favor of Naipi Tourism Operator LTDA.
- For credit cards not issued in Brazil, please make sure that the card is authorized for transactions abroad. Otherwise payment may be denied.