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World Communication Forum in Davos “Communication on Top” (WCF) Davos Congress Centre, 7270 Davos Platz, Promenade 92, Davos, Switzerland 7 – 8 February, 2013 Please type to complete and print to return as a scan by email sent to the Forum Secretariat. For further queries, please call: +41 435 000 683 ext. 219, or email us at: office@forumdavos.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

; ; ;

Organization: Position held:

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Postal address:

;

; ;

City:

; Postal code:

; Country:

Tel: (international code-city area-number) : Mobile: (international code-city area-number) Fax: (international code-city area-number) Email: Do you need a formal invitation for obtaining a visa: Type “x” in the middle of the appropriate box

; ; ; ; ;

-yes;

-no

Contact person (if different than the participant): ; Company position: ; Company name and address: ; Phone and email: ;


Forum fees:

Registration only*

Package*

Full Package*

Please, type “x” in the middle of the appropriate box!

(forum sessions and breaks)

(+ 3* hotel for 3 nights) bed in a shared double room

(+ 3* hotel for 3 nights , transfer) (+ C4F awards & gala) bed in a shared double room

Early Bird From 1st Aug 2012 Up till 15th Oct 2012

Standard From 16th Oct 2012 Up till 10th Dec 2012

Last minute From 11st Dec 2012 Up till 1st Feb 2013

890 euro

1260 euro

1680 euro

1010 euro

1350 euro

1780 euro

1120 euro

1480 euro

1950 euro

Single Room, 3 nights: 6, 7, 8 Feb’13 -

NB: No accommodation!

120 euro

th

C4F Gala Dinner, 7 Feb 2013 150 euro Book online: http://wcf-davos.evenium.net Optional: Please, type “x” in the middle of the appropriate box!

Visit: CERN, Geneva, 6th Feb, 2013 420 euro Book online: http://wcf-davos.evenium.net Dr. Leandro Herrero’s books, at preferential price: Viral Change 19.99 €, Homo Imitans 19.99 € Both books 39.99 € Book online: http://wcf-davos.evenium.net Creative Class Meeting, 7th Feb, 2013 140 euro Book Online: http://creative-class.evenium.net

NB: C4F is included in the Full Package price!

* All fees INCLUDE: Plenary and section sessions listed in the Forum program, lunches and coffee breaks as per program schedule, and a full Participant’s portfolio: program, booklet, note-pad, pen, badge, bag/folder, interpretation. * Registration only & Package fee EXCLUDE: C4F awards ceremony and Gala dinner > select in order to attend! NB: Registration only DOES NOT include hotel, flight, transfer! Package fee DOES NOT include flight and transfer! NB: The 2 Package Fees include accommodation in a shared double room – for a single room, please select the due option!

Official language – English Would you like a translation? Type “x” in the middle of the appropriate box: -yes; -no If yes, to what language? Type “x” in the middle of the appropriate box: Spanish; French; German; Chinese; Russian Payment method: type “x” in the middle of the appropriate box: -Bank Transfer (please, email us to request our bank details!) ; -Pay Pal I understand the booking is subject to the below stated terms and conditions. I would like Top Communication GmbH to invoice: (company name) For (total): Euro – in words: . Euro; Booking Terms and conditions: 1. The contract is with Top Communication GmbH. 2. Any refund of fees will be made only for cancellations received in writing at least 30 days prior to the event. 3. A 25% cancellation charge is due to cover administration costs. No refund for books or printed/other materials/souvenirs. 4. No refunds will be made for cancellations received within 30 days of the event. 5. Top Communication GmbH reserves the right to alter or cancel the program. 6. Provisional bookings made by phone must be confirmed in writing.

Participant’s signature: __________________________ Delete lines before inserting a digital signature or print the form and sign before returning the scan via email!

For accommodation and transfer queries, please refer to our partners in Davos Kloster Destinations: http://www.davos.ch/en/summer/services/contact.html Davos Klosters: info@davos.ch Tel. +41(0)81 4152121; info@klosters.ch Tel. +41(0)81 4102020


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