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On-line Registration Form

Contact Information


Title
Ms Mrs Mr Dr

First name

Last name

Job title

Company name

Address

 

Postal code

City

State

Country

Phone

Mobile phone

Fax

E-mail

Accompanying Person

Please note: Accompanying persons are NOT allowed to take part at the conference. ACCs will join a nice sightseeing programme and will take part at the Welcome Cruise and the Gala Dinner.

Title

First name

Last name



Company Information


You are a (tick all that apply)
Adhesive Producer
Sealant Producer
Raw Material Supplier for the Adhesive Industry
Raw Material Supplier for the Sealant Industry
Equipment/Processes/Accessories
Services
Research Institute
Association
Downstream User

Please indicate your company size
Large company: Headcount >250 and turnover >€ 50 million
SME:  (Medium size: Headcount <250 and Turnover <€ 2 million
Other (e.g. Association, Consultant, Press…)

Please indicate your job title category
General Management
Marketing and Communication
Operations and Technical
Purchasing & Procurement
R&D
Regulatory
Other



Registration Fees

EARLY BIRD REGISTRATION DISCOUNT OF 20% WILL BE GIVEN TO THE FIRST 100 REGISTRATIONS. WE WILL GRANT THE DISCOUNT AUTOMATICALLY.

Conference Participant Registration Fee  (member/non member) - € 1.250,00

Conference Participant (member/non member) including Accompanying Person - € 1.700,00

Accompanying Person - € 450,00

Registration Fees for Speakers & Other

(please also see "Tickets for Social Programme")

Speaker (A&S Formulators, Raw Material Provider, Equipment Suppliers) - € 625,00

Speaker ( Academic-Authorities, NGO´s) - € 500,00

Other

Tickets for Social Programme

Tickets for the Welcome Cocktail Boat Cruise and the WAC2012 Dinner: “A Magical Evening in Paris – the WAC2012 Dinner by Synthomer” are not included in the speakers registration fee. However it is possible to buy these tickets. Please write the number of tickets you would like to buy in the boxes below.

In case regular participants would like to buy additional tickets, please also use the below section.

Welcome Cocktail - "Boat Cruise on the Seine" - € 100,00

WAC2012 Dinner: "A Magical Evening in Paris - the WAC2012 Dinner by Synthomer" - € 200,00

Notes

Services rendered by a non-established VAT-taxpayer – VAT to be paid by the co-contractant - article 283-1 of French VAT legislation (the CGI).

FEICA a.i.s.b.l. is registered in France under VAT nr. FR 74532287844 (SIREN nr. 53228784400015). If your company is not registered for VAT purposes in France, 19,6% French VAT will be charged on our invoices.




Hotel Accommodation

The organizers have made room reservations at the Marriott Paris Rive Gauche Hotel & Conference Center at special conference rates. We suggest to book as early as possible as the number of rooms available for the Conference is limited. The Marriott Paris Rive Gauche Hotel & Conference Center is the appointed conference venue.

The Hotel is nearly fully booked. Hotel room reservation only on request.
Please contact: registration@feica-conferences.com


Accommodation can be booked by credit card in order to guarantee the room. The payment of the hotel room will have to be done in the hotel at departure. To secure your accommodation, please fill out the pdfform (.pdf) and fax it to: +49 2102 964829.

Hotel Booking Cancellation:
All cancellations must be sent in writing and addressed to WAC2012 Registration Office: registration@feica-conferences.com. Cancellations received before July 1st 2012 are free of charge. After this date the hotel room has to be paid in full.



Terms of Payment

Payments - without any charges to the beneficiary - can be made:

by Bank Transfer

Bank transfer must be sent (free of bank charges) to:

Account Name:   FEICA a.i.s.b.l.
Account Address:   Avenue E. van Nieuwenhuyse 6, 1160 Brussels, Belgium
VAT nr. Belgium:   BE 0884 334 548
VAT nr. France:   FR 74532287844
SIREN nr.:   53228784400015
Bank:   ING Belgium SA
Bank Address:   Bd. Du Souverain 230, B-1160 Brussels, Belgium
Account Name:   FEICA a.i.s.b.l.
Account Number:   363-0696653-39
IBAN:   BE13 3630 6966 5339
SWIFT/BIC Code:   BBRUBEBB
With notification:   WAC2012

by Credit Card (Mastercard, Visa)

For security reasons we can not accept credit card payment and information through the Internet. Please fill out the pdfform (.pdf) and fax it to fax number: +49 2102 964829.



Invoicing

Please provide the following information for the correct invoicing:

French VAT N°

Non-French VAT n°

No VAT registration

Invoice to be addressed to
same as above (Contact Information)
other billing address:

Company name

Legal format (ex. : SA, GmbH)

Company address (street, number)

Post code

City

Area

Country



Cancellation Policy

Notice of cancellation should be sent in writing only to FEICA: registration@feica-conferences.com Cancellations are accepted until July 15, 2012 with a refund of 50%. No refunds will be given for cancellations after this date. Please note that all refunds will be made after the conference.



Notes for the organiser

I agree my name, company, position in the company and country to be mentioned in the published conference registration lists.


 


WAC 2012 Registration Office

TCA (Travel & Congress Activities)
Gabriele Hanke

Marienburger Str. 8
40883 Ratingen
Germany

T: +49 2102 66936
F: +49 2102 964829
E: registration@feica-conferences.com