Mine Registration Form

Mine Tour Registration Form

Title:

* Family Name:

* First Name/s:

* Company/Organisation:

Street Address:

City:

State:

Postal Code:

* Country:

Telephone (incluce int. dialing code):

Fax (include int. dialing code):

* Mobile number:

* E-Mail address:

* Accompanying Person/s No One Two Tree

Name/s of Accompanying Person/s:

The cost per participant is U.S. $850.

Your booking will be confirmed on receipt of the funds by CIBJO.

PAYMENT

Please pay your registration fee by wiring funds no later than April 15, 2015 directly to:

CIBJO, the World Jewellery Confederation (beneficiary)

VALIANT BANK

Bundesgasse 4, 3001, Bern, Switzerland

CIBJO – US$ Account

IBAN CH74 0630 0016 6103 9810 0

SWIFT-CODE: VABECH 22

Bank-Clearing 6300

When wiring your funds, please indicate your name and the name/s of accompanying person/s.

For further information, please contact the CIBJO Secretariat by email at: cibjo@cibjo.org

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