APESS BORSELLINO RESIDENCE Fee Payment Proof

APESS Attendee Data for Borsellino Residence fee payment

First Name *

Middle Name

Last Name *

Email Address *

University Affiliation *

Street Address *

Apartment, suite, etc

City *

ZIP / Postal Code *

Country *

Payment Receipt/Invoicing Information

These data are essential to cross-check your payment proof and allowing us to issue your official receipt/invoice. Please, report below the details of who made the payment (e.g. the credit card holder, the structure or the person who made payment or who issued the electronic invoice) for your APESS attendee BORSELLINO RESIDENCE fee payment

Payment Method *Credit Card (via Stripe)Bank TransferElectronic Invoicing requested in advance (Italian Public Administrations)

First Name *

Middle Name

Last Name *

Email Address *

Company / Institution Name *

Street Address *

Apartment, suite, etc

City *

ZIP / Postal Code *

Country *

Transaction Payment Date *

VAT Number / Tax Code *

Additional Payment Notes

Upload Payment Done Proof *Please upload a single PDF file with your payment done transaction proof

No file chosen