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PLEASE PRINT REGISTRATION FORM


Company:_____________________________________________________ Address: _______________________________________________________ ______________________________________________________________ ______________________________________________________________ Country: ______________________________________________________ Tel: ________________________ Fax: ______________________________ Email:_____________ ____________________________________________ VAT No.: __________________________________________________ (Must be completed by all EU Companies) Company activity: ______________________________________________ Invoice address (if different from above): ____________________________ ________________________________________________________ ________________________________________________________


DELEGATE DETAILS (If more than one delegate please photocopy form)


Title: ________ First name: ________________________________________ Surname: ______________________________________________________ Position: _______________________________________________________ Special dietary requirements: _________________________________ Signature: _______________________ Date: _________________________


PAYMENT DETAILS All payments to be made in Euros


The full delegate fee is €1100 per delegate FEES PAID - please tick box and write amount:


q Early bird rate: €990 (Until 14th December 2012)


q Delegate fee thereafter: €1100


q Table top exhibition: €2050 (Includes one free delegate place)


q Conference dinner: €79 Total: METHOD OF PAYMENT


On receipt of this registration form your credit card will be debited. You will be sent an invoice in 5-10 working days.


q Bank Transfer quoting: ‘Applied Market Information Ltd. - ‘Pipeline Coating 2013’ to: Commerzbank, Filiale Düsseldorf, Breite Straße 25, 40213 Düsseldorf, Germany Account number: 1024710


Bank No. 300 400 00 IBAN: DE93 3004 0000 0102 4710 00 SWIFT: COBADEFFXXX


q Visa / Mastercard / Eurocard / JCB -


- -


Name of cardholder: ____________________________________________ Expiry date: _____________________ 3- digit security code: ____________ Cardholder’s signature:___________________________________________ Card Billing address: _____________________________________________ ______________________________________________________________ Post / zip code: _________________________________________________ Country: ______________________________________________________ Tel: ________________________ Fax: ______________________________ Email:_____________ ____________________________________________


___________ ___________


___________ ___________


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PIPELINE COATING 2013 CONFERENCE INFORMATION


Date and location 18 - 20 February 2013 Austria Trend Hotel Savoyen Vienna Rennweg 16 1030 Vienna, Austria Tel: +43 1 206 33 0 Fax: +43 1 206 33 9210


Registration fee The registration fee includes attendance at all conference sessions, the welcome cocktail reception, lunch and refreshment breaks on both days, and a set of conference proceedings.


• Early bird registration: Register before 14th December 2012 for only €990. Thereafter the cost is €1100.


• Group rates: For companies wishing to register two or more delegates, group discounts are available. Please contact Ms. Sabine Prack for more details.


Pipeline Coating 2013 table top exhibition A limited number of table top exhibition spaces are available in the registration area and coffee lounge directly outside the conference room. The table top exhibition fee is only €2050 and includes 1 free delegate place. Exhibitors may either use tables provided by the hotel (120 x 45 x 75 cm), or bring their own stand or display.


Sponsor this event and promote your company A variety of sponsorship opportunities are available at this event that can help to promote and enhance your company’s products and services to this highly targeted international audience. For further information, please contact the Conference Organiser on: +44 (0) 117 924 9442.


Social events The social events organised for Pipeline Coating 2013 will provide an ideal setting for delegates and speakers to mix business with pleasure.


• Welcome cocktail reception: A welcoming cocktail reception will be held on the first evening. All delegates are invited to attend and it will offer an excellent opportunity to meet speakers and other colleagues. The welcome cocktail reception will run approximately from 18:00 to 19:30 and is included in the delegate fee.


• Conference dinner: All delegates are warmly invited to attend the conference dinner, which will take place at a local restaurant on the evening of 19th February 2013. The additional cost is €79.


Hotel accommodation Delegates are responsible for booking their own accommodation. AMI has negotiated a limited number of discounted rooms for attendees who make their reservations by 27th December 2012. Please contact the reservation department at the Austria Trend Hotel Savoyen Vienna to receive the special room rate of €120 for a single room or €140 for a double room (breakfast included).


The hotel only accepts reservations on the official booking form, which can be downloaded from our website: www.amiconferences.com. (click on Pipeline Coating 2013 followed by accommodation). Fill in the form and fax or email it to the reservation department: Fax: +43 1 20633 9110 Email: reservierung.savoyen@austria-trend.at


Cancellations Full refunds, less a cancellation charge of €200 will only be made on cancellations received prior to 18th January 2013. Thereafter we regret that no refunds can be made. Delegates may be substituted at any time. Please note that refunds will not be given on table top bookings or dinner places.


CONFERENCE HOTLINE


SABINE PRACK, SENIOR CONFERENCE ORGANISER Applied Market Information Ltd. 45-47 Stokes Croft, Bristol BS1 3QP, United Kingdom Tel: +44 (0) 117 924 9442 Fax: +44 (0) 117 311 1534 Email: sp@amiplastics.com


The latest programme, including any new speakers or changes to the schedule can be viewed on our website: www.amiconferences.com


Fax back to +44 (0) 117 311 1534


CONFERENCE BROCHURE


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