ANZCCJ & ICCJ & SCCIJ - Joint Chamber Evening April 24th, 2014
Limited to 40 seats. Priority will be given to ICCJ Members.
40席限定。ICCJ会員優先
Registration Deadline: April 18th.
申込締め切り: 4月18日

Payment procedure.
After this form has been sent, you need to complete the payment BY APRIL 18TH by transferring the full amount for the purchased tickets to the following account:
Tokyo-Mitsubishi UFJ Bank Kojimachi-Chuo Branch (015)
Current Deposit No. 1084763, The Italian Chamber of Commerce in Japan.
The transfer description must be the following: "A24 Name Surname".
You will receive a confirmation e-mail only after the payment has been confirmed.

お申込みフォームに記載後、下記の口座番号に代金をお支払い頂きます。ご氏名を記載する際に、必ず「A24　姓 名」とお書き下さい。
口座番号：三菱東京UFJ銀行麹町中央支店（015）
当座預金　1084763　在日イタリア商工会議所
お支払いを確認した後、メールを送りします。

**Once you filled the form, please click "SUBMIT" at the bottom of the page
**記入後、ページ下にある"SUBMIT" をクリックして下さい。

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Surname *
姓
Name *
名
Company *
会社名
Job title
職名
Are you an ICCJ Member? *
ICCJ会員ですか？
Address
住所
Tel *
電話
E-mail *
How many tickets do you need, including yours? *
必要なチケットは何枚ですか？
Please write your guests' surname and name (If you have no guests simply write "n/a") *
同伴者のお名前 (名字と名前)を記入して下さい ( 同伴者のいない方は、「n/a」と記入して下さい )
Disclaimer - Booking conditions *
**Once you filled the form, please click "SUBMIT" at the bottom of the page  Payment procedure. After this form has been sent, you need to complete the payment by transferring the full amount for the purchased tickets to the following account: Tokyo-Mitsubishi UFJ Bank Kojimachi-Chuo Branch (015) Current Deposit No. 1084763, The Italian Chamber of Commerce in Japan.  ***ATTENTION*** The transfer description must be the following: "A24 Name Surname". You will receive a confirmation e-mail only after the payment has been confirmed.   **フォームに記入後、ページ下にある"SUBMIT" をクリックして下さい。 お申込みフォームに記載後、下記の口座番号に代金をお支払い頂きます。 ***注意事項*** ご氏名を記載する際に、必ず「A24　姓名」とお書き下さい。  口座番号：三菱東京UFJ銀行麹町中央支店（015）  当座預金　1084763　在日イタリア商工会議所  お支払いを確認した後、メールをお送り致します。
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