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“Communication on Top” Forum Davos Congress Centre, 7270 Davos Platz, Promenade 92, Davos, Switzerland 9 – 10 February, 2012 Pleasetype to complete and print to return as a scan by email sent to the Forum Secretariat. For further queries, pleasecall: +41435 000 683 ext. 219, or email us at: office@forumdavos.com Personal information – Pleasetype 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:

; ;

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

Registration only*

Package*

Full Package *

(forum sessions and breaks)

(+ 3-star hotel) bed in a shared double room

(+ 3-star hotel and transfer) (+ provided evening options) bed in a shared double room

Early Bird From 1st Aug 2011 Up till 15th Oct 2011

890 euro

1230 euro

1650 euro

1010 euro

1320 euro

1750 euro

1120 euro

1450 euro

1920 euro

Standard From 16th Oct 2011 Up till 10th Dec 2011

Last minute From 11st Dec 2011 Up till 1st Feb 2012

NB: No accommodation!

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

Single room, 3 nights: 8, 9, 10 Feb’12 -

Welcome Party, 8th Feb 2012 C4FGala Dinner, 9th Feb 2012 Closing Buffet, 10th Feb 2012 -

60 euro 150 euro 60 euro

90 euro

NB: All 3 options are included in the Full Package price!

* All fees I NCLUDE: Plenary and section sessions listed in the Forum program, lunches and coffee breaks as per program schedule, and a full Participant’s portfolio, including – program, booklet, note-pad, list of attending participants, pen, badge, bag/folder, interpretation. Registration only and Package fee EXCLUDE Welcome party , C4F Gala , and Closing Buffet – 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 PackageFeesinclude accommodation in a shared double room – for a single room, pleaseselect the due option!

Official language – English Would you like a translation? Type “x” in the middle of the appropriate box: 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!) ;

-yes;

-no

-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 will be made to cover administration costs. No refund is made for books and printed or other materials and souvenirs.


4. 5. 6.

No refunds will be made for cancellations received within 30 days of the event. Top Communication GmbH reserves the right to alter or cancel the program. 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, pleaserefer to our partners in Davos Kloster Destinations: http://www.davos.ch/en/summer/services/contact.html Davos Klosters: info@davos.ch Tel. +41(0)814152121;info@klosters.ch Tel. +41(0)814102020


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