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| Western Union
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You may pay by depositing local money in any Western Union branch giving the information described bellow. After you completed the payment please send this form to our fax (+357-253-44118).
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PLEASE WRITE VERY CLEARLY USING ONLY CAPITAL (BIG) LETTERS
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| First Name: |
Last Name: |
| Country: |
Phone(optional): |
| Email: |
| Confirm Email (Write email again): |
| Account Number(optional): |
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Recipient Information:(Information that you need to provide to the Western Union branch)
| Name: Christiana Mandriotou |
| City: Limassol |
| Country: Republic of Cyprus (Southern) |
| Collection Currency: Cyprus Pounds * |
* We will be able to collect money only in Cyprus Pounds. Please specify this to the Western Union branch.
Client Payment Information: (As in the receipt of Western Union)
| Sender's First Name: |
| Sender's Last Name: |
| The 10 digits Number (MTCN number): |_|_|_|_|_|_|_|_|_|_| |
| Country of payment: |
| Amount transferred: |
| Name of Sales person/Agent in USAGC (Optional): |
To find a Western Union branch location near you use Western Union's site under "FIND AGENT LOCATION". http://www.westernunion.com/
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PLEASE WRITE VERY CLEARLY USING ONLY CAPITAL (BIG) LETTERS
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Please note that all listed prices are including the extra €5 for process and handling.
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By signing below you accept and agree to USAGC Organization's " Terms and Conditions" as published on www.usagc.org website.
I READ, ACCEPT AND AGREE:
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| SIGNATURE |
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After completing all details fax this page to:
Fax: +357-253-44118
or
e-mail to: WesternUnion@usagc.org
PLEASE NOTE:
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Please make sure you completed the payment before send this form.
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Please note that all listed prices are including the extra €5 for process and handling. You have to send the listed amount and not add any amount. USAGC will not return any change or refund any payment after they are received.
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