| One registration form submission per delegate |
| Personal Information: |
Mr
Mrs
Ms |
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| First name for badge: |
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| First name (official): |
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| Last name: |
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| Company: |
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| IAPCO member |
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| Wolfsberg Annual Seminar Alumni |
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| Function / job title: |
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Address:
Street Address
City
Postcode
Country
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| Fax: |
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| Email: |
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| Years of experience in the conference industry (total): |
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| Years of decision-making experience in the industry: |
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| Date of birth: |
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| Age as at next January |
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| Company Activity: |
PCO company
International / National organisation / association
Healthcare Sector (Pharma/Medical Devices) company
Conference Centre
Convention Bureaux
Other (please specify): |
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| Registration Fees and Payment |
| Up to 15 November 2012* |
IAPCO/Wolfsberg Alumni €2900
Non-members/Other €3300 |
| On/after 16 November 2012* |
IAPCO/Wolfsberg Alumni €3200
Non-members/Other €3800 |
I wish to share a twin room [deduct €150 from registration fee]
[only applicable if name of person included]
Name of person with whom I would be sharing:
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I will be transferring on (Enter date)
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| If required, comment on Transfer of Payment |
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Please invoice (please note funds must be received by 30 November for reduced rate to apply)
Bank details for bank transfer:
Bank: UBS, 8021 Zurich, Switzerland
Name: Internat. Ass. of Profess. Congress Organis. IAPCO
SWIFT: UBS WCHZH80A
IBAN: CH72 0023 0230 4083 2060 Y
Account:230-408320.60Y
* For registration applications received on or before 15 November with payment received no later than 30 November. If payment is not received by 30 November, the later amount will automatically be charged.
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Your name and address will be added to the IAPCO database for receipt of future IAPCO documents and The PCO unless you tick this box:
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