Contact us: 31 Zhylyanskaya St., Kyiv 01033, Ukraine davoskyiv@agama-communications.com +38 067 447 41 05
World Communication Forum Davos, Kyiv Session Kyiv, Ukraine 19-20 September, 2016 Please, complete the form by typing in all due information, print it, and return as a scan via email. For further queries, please email us at: davoskyiv@agama-communications.com, Personal information – Please type in all the requested data, as advised below! Title: -Mr. -Mrs. –Ms. -Dr. -other: (please, specify) Type “x” in the middle of the appropriate box Sex: -Male; -Female; Type “x” in the middle of the appropriate box First Name (Given) Middle Name Last (Family) Name
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Tel: (international code - city area - number) Mobile: (international code - city area - number) Fax: (international code - city area - number) Email:
Entry Fees
Registration Only
Type “x” in the middle of the appropriate box!
(one-day Kyiv session)
Regular entry From 20 April 2016 Up till 13 September 2016 Last minute entry From 14 September 2016 Up till 18 September 2016
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10 000 UAH / 350 euro (before WAT) 15 000 UAH / 530 euro (before WAT) NB: No accommodation!
Book online via credit card (NB: no invoice due!) http://forumdavos2016.ticketforevent.com/
Please, claim your due 10% discount from the above-selected Early Bird, Regular entry, Last minute entry, if you are a member of UAPR, MAMI, ICC: 10% special discount for a ____ member!
Contact us: 31 Zhylyanskaya St., Kyiv 01033, Ukraine davoskyiv@agama-communications.com +38 067 447 41 05
Please, claim your due 5% discount from the above-selected Early Bird, Regular entry, Last minute entry, if you are a member of EBA, ACC: 5% special discount for a ____ member!
Please, claim your due 10% discount, if you are buying 2 or more tickets: 10% special discount for the 2nd (+ every next) ticket from the same company/organization Registration fees INCLUDE: The respective panels, sessions, lunches and coffee breaks as per the final Forum Agenda; Participant’s portfolio: prints, booklet, note-pad, pen, badge, bag/folder. Some options - as per the above table!
Payment as Bank Transfer in case of due invoice! (Ask for bank details at: davoskyiv@agama-communications.com) (For online booking via credit card, if no invoice is necessary, please see the link in the above table!)
For a Bank transfer as per Pro-Form Invoice issued upon receipt of this application (official invoice due after event - upon my request!), I’d like SE Pleon Talan, to invoice: (Company) I hereby apply for participation and registration in the above event and accept to pay the due fees’ total amount of: Euro, in words . Euro
Signature: _________________________ Date: