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DATE AND LOCATION: January 26-28, 2016 Ft. Lauderdale Marriott Coral Springs 11775 Heron Bay Boulevard Coral Springs, FL 33076, USA Tel: +1 954 753 5598


REGISTRATION FORM


Thermoplastic Concentrates 2016 January 26-28 2016 Ft. Lauderdale Marriott Coral Springs Golf Resort, Coral Springs, FL, USA


Ft. Lauderdale Marriott Coral Springs


HOTEL ACCOMMODATION The conference fee does not include lodging. We have negotiated a special rate of $154 per night for a single or double occupancy at the Ft. Lauderdale Marriott Coral Springs. To make a reservation, please contact the hotel's reservation department at +1 954 753 5598 by January 4, 2016 and indicate that you will be attending “AMI’s Thermoplastic Concentrates 2016 conference” to qualify for the special room rate. The hotel rate is guaranteed for a limited number of rooms so do not delay in making your reservation for a room at the conference location.


REGISTRATION FEE Register before November 20, 2015 for only $1090. Thereafter, the fee will be $1390. Registration includes all sessions, conference proceedings, the cocktail reception, luncheons and break refreshments.


GROUP RATES For companies wishing to register two or more delegates, group discounts are available. Please contact the Conference Coordinator for more details.


SPONSOR THIS EVENT AND PROMOTE YOUR COMPANY AMI events are more than just arenas for listening and networking. They also represent highly targeted opportunities to enhance your image and promote your products and services to an international audience.


Each event offers the following unique awareness building opportunities: sponsorship of the cocktail reception, lunches, coffee breaks, and much more. For further information, please contact the Conference Coordinator at +1 610 478 0800.


EXHIBITION PACKAGE This package includes an exhibition space in the conference room where we will be hosting registration, the cocktail reception and coffee breaks, giving exhibitors maximum exposure. It also includes 1 free delegate place. Exhibitors may either use tables provided by the hotel or bring their own stand or display. A limited number of tables are available and are assigned on a first come, first serve basis. The cost of this package is $2090. Please note: When applicable, exhibitors are responsible for any electricity and/or handling fees involved with their booth. For further information, please contact the Conference Coordinator.


SOCIAL EVENTS The social events organized for AMI’s Thermoplastic Concentrates 2016 conference will provide an ideal setting for delegates and speakers to mix business with pleasure. On the first evening, everyone is warmly invited to attend the cocktail reception.


SUBSTITUTIONS / CANCELLATIONS Delegates may be substituted at any time at no charge. We ask that you provide ample notification of substitution so that materials can be prepared. Full refunds, less an administrative charge of $200 will only be made on cancellations received prior to November 20, 2015. We regret that we cannot make refunds on cancellations received after this date or for no-shows at the conference. Please note that refunds cannot be made on table top bookings or sponsorship packages.


FAX FORM TO: +1 610 478 0900


CONFERENCE HOTLINE Ms. Stephanie Berchem, Conference Coordinator Applied Market Information LLC


Image courtesy of:


Company: ______________________________________________ Address: _______________________________________________ _______________________________________________________ Tel:_______________________ Fax: _________________________


Company activity: _______________________________________


Delegate Details If more than one delegate please photocopy form Title: _______________First name:__________________________ Surname: ______________________________________________ Position: _______________________________________________ Email: __________________________________________________ Special dietary requirements: ______________________________


Payment Details Please make payments in US Dollars ($) q


Delegate fee q q


q q


q (thereafter)


(before November 20, 2015) Delegate fee


Exhibition package


Golf tournament Golf clubs


(includes exhibition space and one delegate space)


$1090 ___________ $1390 ___________ $2090 ___________


$99 $40


(Please circle: LEFT or RIGHT handed) Golf handicap ___________


Method of Payment Payment terms are NET 30


q q q


By Check: In US Dollars ($), made payable to “Applied Market Information LLC”


Bank Transfer: Please call or email for banking information. Note: You are responsible for any bank charges involved with the transaction.


Visa/Mastercard/Amex My card number is: Tel: +1 610 478 0800


1210 Broadcasting Road, Suite #103 Fax: +1 610 478 0900 Wyomissing, PA 19610, USA


Email: sb@amiplastics-na.com


Please make copies of this registration form for others to use or download a PDF file copy of the brochure from our web site at www.amiplastics-na.com


Name of cardholder: _____________________________________ Expiration date: _____________________Security code:_________ Billing address:__________________________________________ __________________________________Zip code:____________ Cardholder’s signature: ___________________________________ Date: __________________________________________________ Invoice email (if different from above):________________________


___________ ___________


Total: ___________


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