STAR' 2001  

With the support of
the Balearic Islands University

Credit card enclosed form


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Please charge my

VISA
________           AMERICAN EXPRESS ________

Name of the card holder: _______________________________________
(As it appears on the card)

Address of the card holder: _____________________________________
____________________________________________
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Credit Card Number:  __ __ __ __   __ __ __ __  __ __ __ __  __ __ __ __

Date of expiration:  ______ / _______




Signature of the card holder:   __________________  Date: _________

Please send this form correctly typed by e-mail to: dpsjpp0@ps.uib.es or by postal mail to: Javier Pérez Pareja Departament de Psicologia Facultat de Psicologia Universitat de les Illes Balears Ctra. de Valldemossa, km. 7'5 07071 Palma de Mallorca Balearic Islands     (Spain)