Filtex 2008 Registration Form

7> 8 October 2008 Cologne (Germany) REGISTRATION FORM to be returned to 157 Avenue E. Plasky – 1030 Brussels – Belgium T. +32 2 734 93 10 | F. +32 2 733 35 18 E-mail info@edana.orgWebsite www.edana.org Please fill in clearly in block capitals Mr Ms Other ………………………………. First Name ..................................................................... Last Name .............................................................................. Company ......................................................................................................................................................................... Job Title .................................................................................................................................................................................... Address ..................................................................................................................................................................................... Post Code ........................................................................... City .............................................................................................. Country .............................................................................. VAT Number.............................................................. (mandatory) Direct Phone ....................................................................... Direct Fax..................................................................................... Website ............................................................................. Email ........................................................................................... Date ? ? y ? ? y 2008 Signature ………………………………………...................... __________________________________________________________________________________ F E E S Conference & Exhibition (including 19% VAT for Germany) EDANA Member € 946 Non-Member € 1185 Fee includes entrance to the Conference & the Exhibition, 2 lunches and 1 evening cocktail, coffees, CD-Rom containing the FILTREX 2008 Conference papers. M E T H O D S O F P A Y M E N T Bank Transfer Payment has been made by bank transfer to: EDANA (indicate delegate and company name) Account N° 310-0760708-23 / ING Agence Val d’Or / B-1150 Brussels / Belgium IBAN BE92 3100 7607 0823 / BIC BBRUBEBB Payment must be free of all bank charges Credit Card AMEX DINERS MASTERCARD VISA Card Number ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? Expiry Date ? ? > ? ? Card holder’s name ................................................................ Signature ........................................................................................... Cancellations No reimbursement for cancellations after 8 September 2008 Before this date, EDANA will deduct €35 to cover handling, bank charges etc.