2008 REACH Workshop Online Registration Form

Reach Workshop Thursday 29th May and Friday 30th May 2008

Please click here to download the online registration form in pdf format (21kb)

EPMA 2008 REACH Workshop Registration Form
Please complete and return this Form
by clicking the Submit Button

Contact details

Mr/Mrs/DR/Other

First Name

Surname

Company / Organisation

Address

Tel

Fax

Email

I shall attend the workshop on
29th - 30th May 2008 (€295)

Yes
No

I shall attend lunch on 29th May 2008

Yes
No

I shall attend lunch on 30th May 2008

Yes
No

I shall attend dinner on Thursday
29th May 2008 (€50)

Yes
No

Please reserve a single room for night of 28th May 2008 *

Yes
No

Please reserve a single room for night of 29th May 2008 *

Yes
No

* Single room at approx. Euros 150 per night

REACH Workshop Payment Options

Please Charge to Credit Card Below
Please Send Invoice (payment required prior to event)

Payment Details

I authorise you to debit my Credit Card:

Card Type:

Card Number:

Vaild Date: Month Year

Expiry Date: Month Year

Security Number:

Card Holders Address:(If different from above)

Please note that after this date hotel bookings cannot be guaranteed.