PRODUCER'S Registration Form

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FORM TO BE RETURNED TO:
Fax : +34 93 247 01 65
[email protected]
PRODUCER’S Registration Form
MEDIMED 2008 [Sitges, October 10-11 & 12]
To be returned by
SEPTEMBER 5,
at the latest
Company:
Name of the producer:
Address:
Postal Code:
City:
Tel. nr:
Country:
Mobile phone:
Fax nr.:
e-mail:
URL:
What do you expect from MEDIMED’08?
Flight details:
Arrival:
9 October □
10 October□
I come from …………………………………………… Flight number ………………………… Air Company ……………………………………
Flight arrival time at Barcelona Airport ……………………… a.m. / p.m (please, indicate)
Departure:
12 October □
13 October□
I go to ……………………………………………………….. Flight number ……………………… Air Company ……………………………………
Flight departure time ……………………… a.m. / p.m (please, indicate)
Hotel in Sitges (name and address):
………………………………………………………………………………………………………………………………………………………………………………………………………………………………
PARTICIPATION FEE - FIRST 25 REGISTRANTS: 320 EURO
Please, note that a Participation Fee of 350,00 EUR is requested to those producers that are not members of APIMED,
which includes:
- transfer from airport to hotel (return)
- accreditation, printed catalogue, MEDIMED handbag
- welcome pica-pica (Friday)
- catered lunch and dinner-party (Saturday)
- open bar at the venue
- translation service English/French
You are kindly requested to transfer in advance the amount of 350,00 EUR the following APIMED banking account Nr.
(R.I.B.): IBAN ES58 0182-4162-24-0011503292 with BBVA Bank, Barcelona, Spain. SWIFT: BBVAESMMXXX
I understand and agree,
Date:
Name & Signature:
MEDIMED is supported by the MEDIA Programme of the European Union
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