Form - Amhpac

9th AMHPAC Annual Convention
Mexican Produce. International Reference.
Aug 25-26, 2016 • Cancun, Mexico • Fiesta Americana Condesa Hotel
We would like you to fill out this form and email it to: jmgaxiola@amhpac.org
Company/Institution or Department:
Name of Attendee:
Activity:
Gower
Supplier of Inputs or Services
Phone:
Other
Fax
Area code
Number
Area code
Number
Email:
Address:
Street and Number
Area
State
Zip code
Event (s) to attend
Annual Convention
Meeting
Aug 25
Badge Rates (USD)
Aug 26
* Exclusive for partners and sponsors
Member No Member
Until May 31
$ 293
$ 346
From June 1 to 30
$ 309
$ 365
From July 1 to August 25
$ 325
$ 385
Credit Card
VISA
Bank Account of the AMHPAC’s Annual Convention
Asociación Mexicana de Horticultura Protegida AC
Banco Mercantil del Norte SA (Banorte)
Account: 0155780167
Clabe.072 730 00155780167 7
Bank branch: 8008 - Culiacán Seminario
MasterCard
American Express
Number:
Expires:
Safety Code:
Name of cardholder:
The code of safety is usually a 3 or 6 digit code and it is located in the back of the card. In the American Express card, it is located in the front of it.
Please send a copy of your deposit or payment receipt to: gris@amhpac.org
POLICY OF CANCELLATION ONLY FOR BADGE: • All cancellations should be notified in written to: jmgaxiola@amhpac.org
• Cancellation requests should be sent before August 5 in order to receive a refund, with a $50.00 USD charge as a penalty fee.
• After August 8, no refund requests will be accepted.