REGISTRATION FORM

BILLING WORKSHOP
The Changing Nature of Billing Surrounding the IP Environment
hosted by ETIS, Brussels, Belgium, 27th-28th April 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: 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!!!) € 600 + 21%VAT - valid until 1 April
 Non-Members: € 900 + 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: 27-28 April 2006 - Brussels, Belgium
 Hotel: Four Points Hotel by Sheraton
Rue Paul Spaak 15, 1000 Brussels, Belgium.
Please book here >> in order to benefit from the ETIS special rate (145 Euro per night) before 25th March 2006. After that date, rooms will be released and there is no guarantee that there will be rooms available at the same price.
Travel details
 Date and time of Arrival:
 Date and time of Departure:
Billing Workshop and Social Events
Please indicate your participation in the following events by checking the box for yes:
 Billing workshop Day 1 - 27 April
 Executive Banquet Dinner
20:00 - 27 April
(Dress Code: Business casual)
 Billing workshop Day 2 - 28 April