VMA - Online Conference Registration

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First name*:
Last name*:
Company*:
Title:
Email*:
Mobile:
Phone*:
Address:
City:
State/Province:
Zip/Postal code:
Country*:

Register me as:	Prices: Before October 1st / At the door
2008 Member company	Normal €1250 / at the door €1500
Non-Member company or voucher:
1st delegate	Normal €1800 / at the door €2000
Additional delegate	Normal €1500 / at the door €1700
Extras:
	Conference Presentations Video Visit tour on Sunday afternoon - free Evening events voucher for accompanying person Name: I am unable to attend, but please keep me informed of future VMA Conferences.
Total amount:

Please choose your preferred payment method:

Credit Card:	Visa or Mastercard only!
Credit Card type:
Account nr:
Exp. date:
Name on Credit Card :

Bank Transfer:	Please provide the following information with your transfer instructions: “VMA 2008, (Company Name), (Your Name)”
Transfer funds to:	Dexia Banque Internationale Luxembourg - 69, Route d'Esch - L-2953 Luxembourg
Account:	IBAN: LU58 0020 1483 5460 4400 - Name: VMA ASBL - BIC Code: BILLLULL

Check (€ only) :	Please make checks payable to " VMA"
Po nr:

Note:

• Conference Registration . Invitees are requested to confirm their intention to attend as soon as possible by completing the Conference Registration Form above.

• Hotel Accommodation. Invitees are requested to make their hotel reservations as soon as possible by completing and returning the Hotel Registration Form to the Regina Palace Hotel as indicated on the form.

• REGISTRATION FEES MUST BE PAID IN ADVANCE.

• Registration fees include documentation, refreshments, gala event and conference report.

• If you are unable to attend and inform us by fax more than one week prior to the conference: (a) your registration fee can be credited to another colleague or a future conference, or (b) a full refund will be issued.

• For late cancellations or "no-shows", we will retain Euro 600 from your registration fee payment.


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