REGISTRATION FORM


Please complete online www.avmain-mag.com/pma-summit, fax back to +44 (0) 20 8090 6211 or email maria@asi-mag.com Incomplete or partial forms cannot be processed.


* Required information


Personal Information * First Name: * Last Name: * Email Address:


* Price (Please Select)  AIRLINE ONLY 2 Day delegate pass: £495.00 GBP  AIRLINE ONLY 1 Day delegate pass: £295.00 GBP  MARPA Members Rate – 2 Day delegate pass: £495.00 GBP  Non AIRLINE 2 Day delegate pass: £595.00 GBP  Non AIRLINE 1 Day delegate pass: £350.00 GBP  5 x 2 Day delegate package (price of 3): £1,785.00 GBP  Full conference proceedings: £99.00 GBP


Business Information * Company: * Job Title: * Address 1: Address 2: Address 3:


* City: State: Post / Zip Code:


* Country: * Phone: Website:


Badge Information * Badge Name:


Demographics * What is your primary business?


 MRO  Repair Station  Distributor/Dealer  Commercial Airline  Business Aviation/GA  Cargo/Air Freight


 Airframe Manufacturer  Engine Supplier  Manufacturer/Service Provider  Government/Military  Other


Payment Please select:  Credit card  Bank transfer  Cheque


Credit Card Amount to be debited: £  Visa  Visa Electron  Mastercard  Maestro  Amex Card Number: Expiry Date: Start Date: CVC:


Cardholder’s Name: Address 1: Address 2: Address 3: City: State: Post / Zip Code: Country: Signature:


Bank Transfer


Choose this option if you want us to send you an invoice first. Alternatively complete/return the form and THEN you can simply send payment to ‘ASI Publications Ltd’ via Barclays Bank , 38 Hans Crescent, London, SW1X 0LZ, UK. IBAN – GB50 BARC 2047 3570 4311 68 – Sort code 20 47 35 – SWIFT BARCGB22. Please state on the bank payment reference – PMA 2011


Cheque


Make payable to ASI Publications and post to 9 Marsh Brows Formby, Liverpool, L37 3PD UK (No cheques accepted after 14 October 2011)


 Allow others to see that I have registered. (Note: only your name, title, and company information will be shared.)


UK VAT will be added to all UK companies and EU companies unless they provide their VAT no.


VAT Number: Date:


(last 3 digits on reverse)


Visitor Enquiries: Mina Booth I +44 7803 295292 I mina@em-ltd.com I Skype: Mina.Booth


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