PLEASE PRINT OUT FORM AND COMPLETE IN BLOCK CAPITALS


Click here for a PDF of the brochure REGISTRATION FORM


Company: _____________________________________________________ Address: _______________________________________________________ ______________________________________________________________ Country: _______________________________________________________ Tel: ____________________________ Fax: ____________________________ 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: Mr/Mrs/Dr/Other___________________________________________ First name: _____________________________________________________ Surname: ______________________________________________________ Position: _______________________________________________________ Email:________________________________________________________ Special dietary requirements: ________________________________________ Signature: ________________________ Date: ________________________


PAYMENT DETAILS All payments to be made in Euros Please tick box and write amount:


PROGRAMME SPECIAL OFFER PRICES (Until 31st March 2017)


q Early bird admission fee: q Admission fee thereafter:


€990 + €188.10* = €1178.10 _________ €1190 + €226.10* = €1416.10 _________


Table Top Exhibition Package (includes 1 delegate place) q German resident companies


q Site visit to HPF The Mineral Engineers a division of Quarzwerke Group on 28th June


There is a limited capacity for this tour, places are allocated on first come first serve basis


* German VAT charged at 19% (**Only admission fee part of package is VAT chargeable at 19%)


Total: _________


Please note all delegates have to pay the VAT stated above METHOD OF PAYMENT


You will be sent an invoice in 7-14 working days.


qBank transfer quoting:Your invoice and A/C No. or 'Applied Market Information Ltd. - Conductive Plastics 2017’ to: National Westminster Bank Plc. Thornbury Branch, 16 the Plain, Thornbury, Bristol, BS99 5HD Account number:06814077


IBAN:GB63 NWBK 6072 0306 8140 77


Bank No.556138 SWIFT:NWBKGB2L


qPay by Credit Card We accept: Visa / Mastercard Please provide your contact details and we will send you a link to a secure payment gateway via email.


Name:________________________________________________________ Email:_________________________________________________________


€1750 + €332.50* = €2082.50 _________ q Non - German resident companies €1750 + €188.10** = €1938.10 _________


CONDUCTIVE PLASTICS 2017 CONFERENCE INFORMATION


Date and location 27-28 June 2017 Maritim Hotel Heumarkt 20 50667 Cologne Germany


Tel: +49 221 2027 0 Fax: +49 221 2027 835


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


• Early bird registration: Register before 31st March 2017 for only €990*. Thereafter the cost is €1190*.


• 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)


Site visit to HPF The Mineral Engineers a division of Quarzwerke Group Delegates will be taken by coaches to and from the HPF facility in nearby Frechen. There will be a tour of the R&D laboratories and a company presentation followed by a networking break.


Table top exhibition A limited number of table top exhibition spaces are available in the spacious lobby next to the main meeting 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 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 events The social event organised for Conductive Plastics 2017 will provide an ideal setting for delegates and speakers to mix business with pleasure.


• Networking Cocktail Reception A networking cocktail reception will be held on the first evening This offers an excellent opportunity for delegates to meet with speakers and other colleagues. All delegates are invited to attend and admission is included in the delegate fee.


Hotel accommodation Delegates are responsible for booking their own accommodation. AMI has negotiated a room rate of €159 for a single room and €197 for a double (tax, breakfast and Wi-Fi included) at the Maritim Hotel in Cologne until 26th May 2017.


Please make your reservation using the direct hyperlink which can be found on our website www.amiplastics.com (click on ‘Conductive Plastics 2017’ followed by Accommodation)


Cancellations Full refunds, less a cancellation charge of €200 will only be made on cancellations received prior to 26th May 2017. 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 places at any time.


*+19% German VAT


CONFERENCE HOTLINE KAT LANGNER, CONFERENCE ORGANISER 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: kl@amiplastics.com Twitter: @AMIconferences #attendAMI


Fax back to: +44 (0) 117 311 1534 or Email: kl@amiplastics.com


PM


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