Name of exhibitor:*

Person responsible for exhibition stand:

Address:*

Phone/Fax contact:*

E-mail:*

Exhibition space is 150 EUR m²
Exhibitors must register for the Conference at the Member or Non Member rate.

I would like to register for the 17th ICC Annual Conference 2010 *

as an ICC member 225 EUR + 130 EUR exhibition space

Early bird registration by 15th January for ICC members 195 EUR + 130 EUR exhibition space

as non ICC member 255 EUR + 130 EUR exhibition space

Early bird registration by 15th January for non ICC members 235 EUR + 130 EUR exhibition space

We propose to exhibit the following:

Grand total: 0 Euro

Electrical supply required?:

YES

NO

If YES: No. of outlets:

No. of tables:

No. of chairs:

Other requirements:

You will receive a copy of your request to your e-mail address.

Note: Fields marked with * are required.