Cancellation Request Form - CNseg
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Realização | Achievement Apoio Institucional | Institutional Support PARTICIPANT’S DETAILS Last name Middle name First name Tipo de Inscrição PERSON IN CHARGE OF PAYMENT Name Company Telephone Email I,______________________________________________________________________________________, am aware that to all cancellation requests received by April 9 th , 2018, 6:00pm (Brasília local time) reimbursement will be equivalent to 85% (eighty-five percent) of the registration fee paid, and that for cancellations received after April 9 th , 2018, 6:00pm (Brasília local time) the reimbursement value will be equivalent to 50% (fifty percent) of the registration fee paid. Note: All refunds will be done through chargeback reversal via the credit card used for registration. Cancellation Request Form _________________________________________________________ Signature ____________________________________________ City ____________________________________________ Date
Transcript of Cancellation Request Form - CNseg
Realização | Achievement Apoio Institucional | Institutional Support
10 e 11 de abril de 2018Windsor Convention & Expo Center
Rio de Janeiro – RJ
Realização | Achievement Apoio Institucional | Institutional Support
10 e 11 de abril de 2018Windsor Convention & Expo Center
Rio de Janeiro – RJ
PARTICIPANT’S DETAILS
Last name Middle name First nameTipo de Inscrição
PERSON IN CHARGE OF PAYMENTName
Company
Telephone Email
I,______________________________________________________________________________________, am aware
that to all cancellation requests received by April 9th, 2018, 6:00pm (Brasília local time) reimbursement will be
equivalent to 85% (eighty-five percent) of the registration fee paid, and that for cancellations received after
April 9th, 2018, 6:00pm (Brasília local time) the reimbursement value will be equivalent to 50% (fifty percent) of
the registration fee paid.
Note: All refunds will be done through chargeback reversal via the credit card used for registration.
Cancellation Request Form
_________________________________________________________Signature
____________________________________________City
____________________________________________Date
