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Name/Surname*
|
| |
Annabel Braem
|
|
Place of birth
|
| |
Belgium
|
|
Date of birth
|
| |
28/01/1984
|
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Fiscal Code (Italy or 000000 if foreigner)
|
| |
N/A
|
|
Email
|
| |
Annabel.braem@kuleuven.be
|
| FISCAL DATA |
|
Name/Surname – Company
|
| |
KU Leuven LRD Research and Development
|
|
Address
|
| |
Waaistraat 6 – box 5105
Leuven, Vlaams-Brabant 3001
Belgio
Map It
|
|
VAT n. (only for company or University)
|
| |
BE 0419 052 173
|
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Fiscal code (Italy of 000000 if foreigner)
|
| |
N/A
|
|
Payment
|
| |
Carta di Credito
|
|
Carta di credito
|
| |
MasterCard
XXXXXXXXXXXX3236
|
|
Ordine
|
| |
| Prodotto |
Quantità |
Prezzo unitario |
Prezzo |
|
Registration fee (social dinner not included)
|
1 |
490,00 € |
490,00 € |
|
Yes
|
1 |
80,00 € |
80,00 € |
| |
Subtotale |
570,00 €
|
| |
Totale |
570,00 € |
|
