Ana səhifə

Edizioni minerva medica order form for individual subscription

Yüklə 28.5 Kb.
ölçüsü28.5 Kb.

Please download the order form, complete it and forward it with the attachments requested to the following email address:

I wish to subscribe to the journal _____________________________________ Year ________
New Subscription
 Subscription Renewal  Subscriber code no. ____________
 Print
 Print + online
Amount ______________
Payment procedure
I paid on ______________

to EDIZIONI MINERVA MEDICA – Bramante 83-85 – 10126 Torino, by:

 Bank transfer (copy attached)
Bank details: INTESA SANPAOLO Ag. 18 Torino, Bramante 82, 10126

Torino – IBAN: IT45 K030 6909 2191 0000 0002 917 – BIC BCITITMM

Personal details (all fields are compulsory)

First Name __________ Surname __________

Address ______________________________
Post Code _____City __________ Province __
Country ______Telephone ________________
Fax __________ Email___________________

Shipping Details (all fields are compulsory)
First Name __________Surname __________
Address ______________________________
Post Code _____City __________Province
Country _______Telephone ______________
Fax _________ Email___________________

I wish to receive a receipted invoice.  Yes  No
Personal details will be used for invoicing
The details transmitted which you, in accordance with Decree Law no.196/2003 authorise us to handle, will be used solely for commercial purposes and to promote our activities. Updates or cancellation of details should be requested from:
Edizioni Minerva Medica, Corso Bramante 83-85, 10126 - Torino.

Verilənlər bazası müəlliflik hüququ ilə müdafiə olunur © 2016
rəhbərliyinə müraciət