Feedingthe recovery

17&18 October 2012The Square Congress Centre, Brussels

Registration

Company:
Position:
Title:
First Name:
Surname:
Address:
Postcode:
Town:
Country:
Telephone:
(eg. +32 2 514 11 11)
Email:
 
Invoicing details: (if different from above)
Address:
Postcode:
Town:
Country:
VAT Number:
(if applicable)
PO Number:
(if applicable)
 
Fee:    Direct Members (Early Bird Registration) - € 300
  Non-Members (Early Bird Registration) - € 400
  Direct Members (Registration after 1 October 2012 00:00 CET) - € 500
  Non-Members (Registration after 1 October 2012 00:00 CET) - € 600
 
I will :
  be participating at the Gala Dinner (17 October 2012)
  NOT be participating at the Gala Dinner
 
Special Dietary Requirements:
Please specify:
(if applicable)
 
Guest Attendance:   A guest will accompany me at the Gala Dinner (€ 100)
Guest Title:
Guest First Name:
Guest Surname:
Guest Special Dietary Requirements:
Please specify:
(if applicable)
 
To help us cut down on food waste, please tick this box if you will not participate in the buffet lunch at the end of day two (18 October 2012)   
 
  I confirm to have read and accept the General Terms And Conditions.

 
Please let us know if you have any other dietary restrictions, accessibility needs, or requirements.
Comments:

All fields are required.