Please fill in the form, print, sign and send the scan with your company stamp to d.myko@elka.pw.edu.pl until the 15th of February, 2016. No-cost cancellation deadline: the 22nd of February , 2015. After the 22nd of February, 2016, a participant will be charged 50% of the fee. Please send us information for Fair Catalog until the 1st of February, 2016. Registration Form for XVII Job Fair for Electronics Engineers and Computer Scientists at the Faculty of Electronics and Information Technology Warsaw University of Technology ul. Nowowiejska 15/19, 00-665 Warszawa, Poland February the 29th – March the 1st, 2016 Contact: Dorota Myko, mail: d.myko@elka.pw.edu.pl tel. +48 22 234 7081 Institution / Enterprise:….……………………………………………………… ….………….. We’d like to reserve a fair stand nr ……………….. measuring ………………. m2 on February the 29th, 2016* and on March the 1st, 2016*, for the price …………………………………. Euro (prices include 23 % VAT) *delete as appropriate We ask for 10% cost reduction because of participation in former Job Fairs.** **Please underline if concerns. We ask for 20% cost reduction because of presentation of made/designed by our company electronic equipment.*** *** Please underline if electronic equipment made/designed in Poland will be presented. Transfer cost of the payment is covered by the exhibiting company Contact Person: ………………………………………………………………………………….. Tel.: ……………………………………………………………………………………………….. Mob. Tel: ………………………………………………………………………..……………….. E-mail: …………………………………………………………………………..……………….. Department: ……………………………………………………………………………………….. Invoice data Institution name …………………………………………………………………..……………….. Street Address: …………………………………………………………………….……………….. Postcode, town: …………………………………...……………………………….……………….. Country: ……………………………………………………………….…………..……………….. VAT ID.: ………………………………………………………………………….……………….. Name of the company in the form to be placed on a sign of the stand: …………………………………………………………………………………………………………. We would like to use the stand offered by the organizers.* W would like the stand to be modified (to be agreed with the organizers).* …………………………………………………………………………………………………………. We will have our own stand.* Date ………………………….. Signature and Stamp ……………………………