PLEASE PRINT OUT FORM AND COMPLETE IN BLOCK CAPITALS


Click here for a PDF of the brochure REGISTRATION FORM


Company: _____________________________________________________ Address: _______________________________________________________ ______________________________________________________________ Country: _______________________________________________________ Tel: ____________________________ Fax: ____________________________ Email: ________________________________________________________ VAT No.: __________________________________________________ (Must be completed by all EU Companies) Company activity: _______________________________________________ Purchase order No. (if applicable): _______________________________________ 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 USD Please tick box and write amount:


❑ Early bird admission fee: USD1150 (Until 6th February 2015)


❑ Admission fee thereafter: USD1450 ❑ Table top exhibition package: USD2500


(Includes 1 delegate place) Total: _________ METHOD OF PAYMENT


On receipt of this registration form your credit card will be debited. You will be sent an invoice in 7-14 working days.


❑ Bank transfer quoting: ‘Applied Market Information Ltd. - Masterbatch Asia 2015’ to: Thornbury Branch, 16 The Plain, Thornbury, Bristol BS99 5HD Account number: 140 0 034 20760


Bank No. 55 61 38 IBAN: GB62 NWBK 6073 0103 420760 SWIFT: NWBKGB2L


❑ Visa / Mastercard / Eurocard / JCB -


- - If paying by card the following information must be given


Name of cardholder: _____________________________________________ Expiry date: ________________________ 3-digit security code: __________ Cardholder’s signature: ___________________________________________ Card billing address: _____________________________________________ Post / zip code: __________________________________________________


Country: _______________________________________________________ _________


_________ _________


MASTERBATCH ASIA 2015 CONFERENCE INFORMATION


Date and location 9-11 March 2015


Swissôtel The Stamford 2 Stamford Road Singapore 178882


Tel: +65 6338 8585 Fax: +65 6338 2862


Registration fee The registration fee includes attendance at all conference sessions, the Cocktail Reception, lunch and refreshment breaks on all days and a set of conference proceedings.


• Early bird registration: Register before 6th February 2015 for only USD1150. Thereafter the cost is USD1450.


• Group rates: For companies wishing to register two or more delegates, group discounts are available. Please contact the Conference Organiser for more details. (Please note to qualify for the group discount delegates must be booked at the same time, otherwise additional delegates may be charged at full price.)


Masterbatch Asia 2015 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 excellent value for money and includes 1 delegate place. Exhibitors may either use tables provided by the hotel 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) 117 314 8111.


Social event The social event organised for Masterbatch Asia 2015 will provide an ideal setting for delegates and speakers to mix business with pleasure.


• Cocktail Reception: A cocktail reception will be held on the fi rst evening. All delegates are invited to attend and it will offer an excellent opportunity to meet speakers and other colleagues. The Cocktail Reception will run approximately from 17:40 to 19:30 and is included in the delegate fee.


Hotel accommodation Delegates are responsible for arranging their own hotel accommodation while attending theconference. AMI has negotiated a limited number of rooms at the special rate of:


S$275 ++ for a single room S$300 ++ for a single room including Breakfast and Wi-Fi


PLEASE NOTE THIS IS RATE IS ONLY AVAILABLE UNTIL MONDAY 9th FEBRUARY 2015 A copy of the reservation link can be found below or on our website www.amiconferences.com


https://resweb.passkey.com/go/MasterbatchAsia


Alternatively you can contact Ms. Tamara Pfaumann Please state that you are attending Applied Market Information’s ‘MASTERBATCH ASIA 2015’ conference when booking to receive the special rate.


Tel: +65 6431 5589 Email: tamara.pfaumann@fairmont.com


Cancellations Full refunds, less a cancellation charge of USD300 will only be made on cancellations received prior to 6th February 2015. 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 sponsorship packages.


CONFERENCE HOTLINE


ADELE BROWN, CONFERENCE MANAGER Applied Market Information Ltd. 6 Pritchard Street, Bristol, BS2 8RH, United Kingdom Tel: +44 (0) 117 314 8111 Fax: +44 (0) 117 311 1534 Email: ab@amiplastics.com


Tel: ____________________________ Fax: ____________________________ Email: ________________________________________________________ Fax back to: +44 (0) 117 311 1534 or Email: ab@amiplastics.com


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


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