FAC - Exhibitor registration

Exhibitor registration

Please fill in the form below before February 28th, 2010 :

This form is a pre-registration and must be completed before payment. You can be pre-registered and pay later (the applicable rates are according the pre-registration date).

I am already pre-registered and I would like to pay : click here

EXHIBITOR PRE-REGISTRATION FORM

EXHIBITOR INFORMATION - KEY CONTACT
First name *	:
Last name *	:
Company name *	:
Department	:
Address *	:
Post code *	:
City *	:
Country *	:
Invoice address (if different)	:
Phone *	:
Fax	:
Email contact address *	:
Company website address	:
__________________________________________________________________________
Exhibit space selection *	:	10 m2 (2500 € - 2 exhibitors) 15 m2 (3500 € - 2 exhibitors) 20 m2 (4000 € - 3 exhibitors) 30 m2 (5500 € - 3 exhibitors)
How many people would you like to register ?	:
__________________________________________________________________________
2nd Exhibitor Details
First name 2	:
Last name 2	:
Phone 2	:
Email 2	:
__________________________________________________________________________
3rd Exhibitor Details
First name 3	:
Last name 3	:
Phone 3	:
Email 3	:
__________________________________________________________________________
Brief description of your company	:	(1000 characters maximum).
Please submit your company's logo	:	in jpeg, TIF, bmp, png format
Brief exhibit materials description *	:
__________________________________________________________________________
Please indicate any resources you will need for your displays	:	Extension power cord Table 120 x 90 cm (45 x 33 inches) (no extra fees)
Number of tables	:
I bring my own exhibit booth	:
Other : specify your needs	:
__________________________________________________________________________
Registration payment mode	:
I hereby acknowledge *	:
ownership of and give permission to publish my paper, powerpoint presentations and photos
in .pdf, jpeg or gif format in the Proceedings of the Flow Accelerated Corrosion International
Conference FAC2010.
__________________________________________________________________________
* : Obligatory field