PAYMENT FORM FOR CREDIT CARD
为支付会议费用，我愿意用以下信用卡支付：□ Visa信用卡 □ 美国运通卡 □ 万事达卡（信用卡用人民币支付并且将在卡中扣除4%的手续费）
I would like to make the payment for the conference by □ Visa □ American Express □ Master Card （payment by Credit Cards will be charged in RMB and 4% service fee more will be charged by banks from your card）
信用卡号码： 有效期限：
信用卡用户名：
Credit Card No.： Expiry Date：
Name on Card：
我同意从我信用卡中向CAS的国际科学交流中心支付[ ]美元，并由中国银行附加4%的手续费。我已经随信寄出我信用卡双面的清晰复印件。
I consent to the Center for International Scientific Exchanges， CAS debiting my credit card account with the amount of US$ [ ] and the Bank of China is to charge 4% service fee in addition to this amount. I have also sent a clear copy of both sides of the credit card to you along with this form.
签名： [ ] （应和信用卡上名字一致）
Signature： [ ] （should be the same with that on the card）
日期：
Date
注：
以上是由[ ]博士支付Note：
The payment above is made for Dr. [ ]
通讯地址：[ ]女士
国际科学交流中心，CAS
ICEC20秘书处
中国北京三立和路52号，邮编：100864
电话：[ ]；
传真：[ ]
电子邮件：[ ] Correspondence：
Ms. [ ] Center for International Scientific Exchanges， CAS
Secretariat of ICEC20 52
Sanlihe Rd.， Beijing 100864， China
Tel： [ ]；
Fax： [ ]
Email： [ ]
