DELEGATE - ONLINE REGISTRATION FORM                                                                  

Please fill in the required fields in ALL CAPS. The information provided will appear on your name badge and the participants list.

* Required Fields

TITLE:         Mr Mrs Ms Dr Prof    Other
FIRST NAME: *
LAST NAME: *
ORGANISATION: *
JOB TITLE:
ADDRESS: *
CITY:
POSTAL/ZIP CODE: *
COUNTRY: *
TELEPHONE: *
FAX:
EMAIL: *

Please indicate the events that you will attend:

Evening Reception -3 December 2008
Seminar - 4 & 5 December 2008
Seminar - 4 December 2008 ONLY
Seminar - 5 December 2008 ONLY

Please tell us if you have any special requirements:

Dietary                
Special Needs     

Delegate Rate:

€700.00
If you are registered for French VAT you do not have to pay tax on your rate.
Please provide your VAT number to prove your eligibility:

€700.00 plus 19.6% VAT

Payment Method:

Credit/Debit Card (all card transactions incur an additional non-refundable 1.5% administrative charge)
Request an Invoice

Cancellation Charges:

If you cancel your registration within the periods set out below you will be charged the following percentages of your delegate rate:

Cancellation % of Delegate Rate Charged
Before 1 September
0
From 2 September - 28 September
15
From 29 September - 2 November
50
From 3 November - 16 November
75
From 17 November
100

All cancellations must be communicated in writing to Charis Desinioti (cd@anniversaryseminar.org).

PLEASE VERIFY THE INFORMATION BEFORE SUBMITTING THE FORM.