Please fill in this form to book your place at the Forum 2008
 

(Indicates required fields)

Mr       Mrs       Miss  

Last Name    First Name

Job Title               Email 

Phone                                   Fax

Company   

Company Phone    Company Fax

Address 1                Address 2

City           

County/State            Zip Code

Country     

Company Web Site :   

Company Email :       

Please state the status of your company at this address : 

Main Activity :  Components Manufacturer (*)
                              Components Distributor (*)
                              Others 
(*) including related products such as Modules, Test, Tools, Software...

Manufacturers, state your main product area :                 

Distributors, state your main activity :                              

If you are not a component Manufacturer or Distributor,
please state your main company's industry or service : 

Select the appropriate table and numbers within it, and complete the column corresponding to the currency in which you wish to pay...

The above company is paying for the delegates listed below, at the standard rate:

EUR

GBP

ONE

Main Delegate only at registration fee �1150 EUR 
Additional Delegates at registration fee per head �1000 EUR 
Main Delegate one day only at registration fee per head �550 EUR no dinner
Additional Delegates one day only at registration fee per head �500 EUR no dinner
Main Delegate 2 day ticket at registration fee per head �1000 EUR no dinner
Additional Dinner Guest(s) at �150 EUR 
 

TOTAL AMOUNT

EU companies, enter your VAT registration number :

There will not be any payment facilities at the Conference itself.

If you have been given a "Recommended Delegate" code,
please enter it here:

An invoice will be sent with instructions for payment.

Cancellations and Substitutions : You may make a delegate substitution at any time.

                                     

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