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信用卡付费表中英文对照

15

PAYMENT FORM FOR CREDIT CARD

为支付会议费用,我愿意用以下信用卡支付:□ Visa信用卡 □ 美国运通卡 □ 万事达卡(信用卡用人民币支付并且将在卡中扣除4%的手续费)

I would like to make the payment for the conference by □ Visa □ American Express  □ Master Card (payment by Credit Cards will be charged in RMB and 4% service fee more will be charged by banks from your card)

信用卡号码:                                    有效期限:

信用卡用户名:

Credit Card No.:                                                        Expiry Date:

Name on Card:

我同意从我信用卡中向CAS的国际科学交流中心支付[ ]美元,并由中国银行附加4%的手续费。我已经随信寄出我信用卡双面的清晰复印件。

I consent to the Center for International Scientific Exchanges, CAS debiting my credit card account with the amount of US$ [ ] and the Bank of China is to charge 4% service fee in addition to this amount. I have also sent a clear copy of both sides of the credit card to you along with this form.

签名: [ ] (应和信用卡上名字一致)

Signature: [ ] (should be the same with that on the card)

日期:

Date

注:

以上是由[ ]博士支付Note:

The payment above is made for Dr. [ ]

通讯地址:[ ]女士

国际科学交流中心,CAS

ICEC20秘书处

中国北京三立和路52号,邮编:100864

电话:[ ];

传真:[ ]

电子邮件:[ ] Correspondence:

Ms. [ ] Center for International Scientific Exchanges, CAS

Secretariat of ICEC20 52

Sanlihe Rd., Beijing 100864, China

Tel: [ ];

Fax: [ ]

Email: [ ]

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