REGISTRATION FORM

ETIS Conference 2007
Innovative Telecommunication Services & Business Models to Win New Markets
7/8 June 2007 - Brussels, Belgium
* Please note that the fields with the red stars are mandatory fields.

Participant's details
Last name:	*
First name:	*
Company:	*
Mailing address:	*
Zip code:	*
City & country:	*
Telephone:	*
E-mail address:	*
Conference fee
Payment:	The full participation fee should be paid at the time of registration.
Cancellation policy:	Your participation may not be possible due to unforeseen circumstances. We would be pleased to welcome a deputy or colleague to take your place. However, if you are forced to cancel without substituting, we will be unable to make a refund.
ETIS Members:	Free for ETIS Members, Speakers & Sponsors
Non-Members: (early birds!!!)	€ 900 + 21%VAT - valid until 1 May
Non-Members:	€ 1200 + 21%VAT
Invoicing address for non members:
VAT Number:
Payment details will be sent out together with the invoice
Venue and Hotel Details
Venue:	Management Centre Europe Rue de l’Aqueduc 118, 1050 Brussels
Dates:	7/8 June 2007 - Brussels, Belgium
Hotel:	Capitol Hotel* www.hotelcapital.be 85 euros single - 95 euros double (Reservation code: # 369-ETIS) White Hotel* www.thewhitehotel.be 115 euros single - same price for double (Reservation code: ETIS Conference) Bristol Stephanie**** www.bristol.be 175 Euros Single 202 Euros double (Reservation code: ETIS Conference) * Please quote the correct reference to guarantee the special conference room rate.
Travel details
Date and time of Arrival:
Date and time of Departure:
Conference, Workshops and Social Events
Please indicate your participation in the following events by checking the box for yes. Please only select one session on day 2.
Conference Day 1 - 7 June Common session
Executive Banquet Dinner 20:00 - 7 June (Dress Code: Business casual)
Day 2, June 8 - Session A Business Trends & IT Consequences
Day 2, June 8 - Session B Billing Opportunities & Challenges
Day 2, June 8 - Session C Information Security