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Name/Surname*
|
| |
Jhuliene Elen Muro Torrento
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Place of birth
|
| |
Brazil
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|
Date of birth
|
| |
17/07/1997
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Fiscal Code (Italy or 000000 if foreigner)
|
| |
000000
|
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Email
|
| |
jhuliene.torrento@unesp.br
|
| FISCAL DATA |
|
Name/Surname – Company
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| |
Jhuliene Elen Muro Torrento
|
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Address
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| |
Rua Rubens de Almeida Françoso, 58
Agudos, São Paulo 17123-112
Brasile
Map It
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VAT n. (only for company or University)
|
| |
0000000
|
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Fiscal code (Italy of 000000 if foreigner)
|
| |
0000000
|
|
Payment
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| |
Carta di Credito
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|
Carta di credito
|
| |
Visa
XXXXXXXXXXXX7496
|
|
Ordine
|
| |
| Prodotto |
Quantità |
Prezzo unitario |
Prezzo |
|
Registration on line (fee includes the possibility of poster submission)
|
1 |
200,00 € |
200,00 € |
|
No
|
1 |
0,00 € |
0,00 € |
| |
Subtotale |
200,00 €
|
| |
Totale |
200,00 € |
|
