SUBSCRIPTION FORM MAGAZINE EURE

In order to subscribe or to acquire the EURE Magazine, it completes the form and send to:

• Mirta Saldías
  Secretary
  Revista EURE
  El Comendador #1916
  Casilla 16002, Correo 9
  Código Postal 7530091
  Santiago-Chile
  Teléfono: (56-2) 3545511
  Fax: (56-2) 3545517
  E-mail: eure@eure.cl

1. PERSONAL DATA

Complete name:	RUT:
Address :	E-mail:
Commune/colony/district:	city:
Postal code:	Country:
Telephone:	Fax:

2. MARK WITH AN X ITS ORDER

2.1. Subscription ( )

	1 year (3 numbers)	2 years (6 numbers)
Chile	$25.000.-	$45.000.-
South America, Central America and México	US$ 120.-	US$ 200.-
Canada and EE.UU.	US$ 150.-	US$ 250.-
Rest of the world	US$ 175.-	US$ 300.-

2.2. Individual numbers: indicate el/los numbers(s) that wish ( )

	Price	Number(s) asked for(s)
Numbers 106-116	$ 15.000.- / US$ 32.-
Numbers 95-105	$ 10.000.- / US$ 21.-
Previous	$ 7.000.- / US$ 14.-
TOTAL

3. SELECT AN MODE OF PAYMENT

3.1. Check shipment ( )

To send crossed check to name of the:
Pontificia Universidad Católica de Chile,
Square 16002, Mail 9, Santiago of Chile.

3.2. Banking deposit in Chile ( )

Bank	:	Santander Santiago	To name of	:	Pontifical Catholic University of Chile
N° counts	:	08-0104190-8

3.3. Banking deposit abroad ( )

Bank	:	CITIBANK	Address	:	111 Wall Street, New York, N.Y.
N° counts	:	36996989	ABA	:	021000089
SWITF	:	CITIUS33	Contact Executive	:	Ximena Jaramillo
Currency	:	US$ dollars

Once made the deposit, to send the comprobante by fax or postal mail.

3.4. Credit card ( )

Credit card N°:
Date of victory:	Code of verification:
Date:	signature:

All subscriptions and changes of address should be sent to the address below.