|
Name/Surname*
|
| |
Ketul Popat
|
|
Place of birth
|
| |
India
|
|
Date of birth
|
| |
28/02/1977
|
|
Fiscal Code (Italy or 000000 if foreigner)
|
| |
0000000
|
|
Email
|
| |
kpopat@gmu.edu
|
| FISCAL DATA |
|
Name/Surname – Company
|
| |
George Mason University
|
|
Address
|
| |
4400 University Drive 1J7
Fairfax 22030
Stati Uniti
Map It
|
|
VAT n. (only for company or University)
|
| |
000000
|
|
Fiscal code (Italy of 000000 if foreigner)
|
| |
000000
|
|
Payment
|
| |
Carta di Credito
|
|
Carta di credito
|
| |
Visa
XXXXXXXXXXXX4894
|
|
Ordine
|
| |
| Prodotto |
Quantità |
Prezzo unitario |
Prezzo |
|
Registration 1 day
|
1 |
300,00 € |
300,00 € |
|
Yes
|
1 |
80,00 € |
80,00 € |
| |
Subtotale |
380,00 €
|
| |
Totale |
380,00 € |
|
|
