PSI Credit Card Application
Paul Scherrer Institut Credit Card Entry
Credit Card Data
If you would like to pay into the account of "
" please fill in the following form completely (all information will be encrypted):
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Card verification value
(last three numbers on the back of the card):
Participiant name(s), mandatory only if
cardholder's name is not the same as the participiant's name
payment is to be made for several participants of the same organization