REGISTRATION FORM

ETIS Community Gathering
hosted by BT in Ipswich, United Kingdom on 14/15 November 2006
 * 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: This event is free of charge for ETIS Members, Associates & Partners
 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.
Venue and Hotel Details
 Venue: BT's Innovation and Research Centre in BT’s Adastral Park
Ipswich, United Kingdom
 Dates: 14/15 November 2006
 Hotel: Hotel booking information will be sent to you by the ETIS Central Office in the coming weeks as the practical details are finalized.
Travel details
 Date and time of Arrival:
 Date and time of Departure:
Community Gathering and Social Events
Please indicate your participation in the following events by checking the box for yes:
 Gathering Day 1 - 14 November
 Executive Banquet Dinner
20:00 - 14 November
(Dress Code: Business casual)
 Gathering Day 2 - 15 November