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Registration
 

55TH AMBASSADORS CUP-INDIA
REGISTRATION FORM - March 8-12, 2006
 
Last Name :
First Name :
Address :
City :
Zip :
State :
Country :
Phone :
Fax :
E-mail :
Accompanying Person :
Last Name :
First Name :
Players Handicap :
FIP Bank Wire Instruction
Fedration of International Polo

BNP Paribas
10A Boulevard Royal
L-2093 Luxembourg

Tel : +352 (46) 46 43 93
Fax : +352 (46) 46 91 30
Account Number in $ : IBAN: LU 90 0220 0541 08C0 0840
Account Number in € : IBAN: LU 50 0220 0541 08C0 0978
BIC: BNPALULL
Telex: 2332 PARIBLU

It is VERY IMPORTANT THAT information below be completed and Submit it.
Amount : $500
Date of Wire* :  (dd-mm-yyyy)
Name of Bank* :
Transfer Number* :
 
 

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