SECURITY NOTICE: The submission of this form will be performed with a
reliable encryption. If the level of security provided by this
transmission (anonymous certification) does not satisfy you, you are
kindly asked to submit only the first 12 digits of your credit card. The
last 4 digits of your credit card with your name should then be sent by
fax to the DEXA registration office (FaxNo: +43-732-2468-9308).