StomatologyEduJournal1-2015 | Page 88

SUBSCRIPTION SUBSCRIPTION S T O M A T O L O G Y E D U J O VOLUME I ISSUE 1 SPRING 2014 U R N J A L A WORLD OF EDUCATIONAL RESOURCES FOR EACH PRACTICE I want to subscribe to J q 1 year Subscription (4 issues of the journal) – 120 RON (60 Euros for foreign subscribers) q 2 years Subscription (8 issues of the journal) – 200 RON (100 Euros for foreign subscribers) q Single Issue – 60 RON (18 Euros for foreign subscribers) Please send the filled subscription at the following e-mail: [email protected] PLEASE COMPLETE ALL THE SUBSCRIPTION FIELDS IN CAPITAL LETTERS! Name…………………………………………………. Surname ……………………………………………………………… Mrs. Mr. Ms. Home Address City………………………………………….. Sector…………………………. District……………………………………….. Post office code…………………………….. Mobile phone………………………………………………………………….. E-mail:………………………………………………………… Web…………………………………………………………… Student Resident Specialist doctor Primary doctor Competence…………………………………………………………………………………………………………………… Institution………………………………………..……………………………………………………………………………… Activity domain: Private Public Department…………………………………………………… Position……………………………….……………………… Specialty…………………………………………………….. Institution address…………………………………………… City………………………………………….. Sector……………………………………. District……………………..……… Post office code……………………………….. Phone…………………………………………………….………………… E-mail:…………………………………………………………. Web…………………………………………………………… CUI (Institution Unique Registration Code) ………………………………………………..………………………………… Yes No VAT Payer: Invoice – please fill all the necessary details for invoice: Name…………………………………………………… CNP (Personal Identification Number)………………………….. Or Institution …………………………………… CUI (Institution Unique Registration Code)………………………………. Address for sending the printed version of MEDIA SYSTEMS COMMUNICATION journals: Home Institution Date………………………. Signature…………………………. After filling the subscription, please send it together with the proof of payment to: SC MEDIA SYSTEMS COMMUNICATION SRL, Electromagnetica Business Park, Rahovei Street, no 266-268, 2nd Building, 2nd Floor, 22-23 offices, 5 Sector, Bucharest, Romania, post office code 050912, or