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Civility

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BILLING ADDRESS / ADRESSE DE FACTURATION

University name / Company / PERSONAL NAME:

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your reference / PO number:

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Payment by

Tariff is for one civil year, from 1st January till 31 december 2021

at receipt of your form sheet an invoice will be send

Please send the check (order: "APGI") to the the following address:

APGI

Faculté de Pharmacy, Université de Lille
3, rue du Professeur Laguesse
59000 Lille, France

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