/ EMC EUROPE 2016 WROCLAW
International Symposium and Exhibition
on Electromagnetic Compatibility (EMC)
September 5-9, 2016, Wroclaw, Poland

EXHIBITOR’SAPPLICATION FORM

:

Please return completed form
before July30, 2016 to:
EMC EUROPE2016
Wroclaw University of Technology, Faculty of Electronics
Department of Telecommunications and Teleinformatics
Wyb. Wyspiańskiego 27, 50-370 Wroclaw, POLAND
Phone: +48 71 3204582 ,
Phone/Fax: +48 71 3223473
e-mail: / Standard booth package includes:
  • standard booth construction (2m × 2m) available September 6-8, 2016
  • one table or counter with two standard chairs
  • power supply and lighting
  • fascia board with exhibitor logo and name
  • short company profile in Exhibitors Book
  • company presentation (20 min)
  • social packet for single Exhibitor’s representative including: coffee breaks and lunches on 6 -8 September 2016, single invitation to cocktail and banquet
/ Double-standardbooth or large booth package includes:
  • booth construction (4m × 2m or 3m x 3m)available September 6-8, 2016
  • one table or counter with two standard chairs
  • power supply and lighting
  • fascia board with exhibitor logo and name
  • short company profile in Exhibitors Book
  • company presentation (20 min)
  • social packet for two Exhibitor’s representative including: coffee breaks and lunches on 6 -8 September 2016, two invitations to cocktail and banquet

1.Contact information:

Company name
Address
Phone, fax, e-mail, www
Tax ID:
Contact person:
name & surname, title:
organization:
phone, fax, e-mail:

2.Order details (note: all prices are including 23% Goods and Service Tax):

2.1. Booth size:

Standard booth size (2m×2m) / €1000 × / = / €
Double-standard booth (4m×2m) / €2000 × / = / €
Additional space in increments of 2m2 (price per 1m2) / € 250 × / m2 = / €
Large booth size (3m×3m) / €2250× / = / €
Additional space in increments of 3m2 (price per 1m2) / € 250 × / m2 = / €

Sketch of the booth and/or its arrangement if different from the standard:

2.2.Additional items to standard package:

a display cabinet / € 35 × / = / €
additional table / € 30 × / = / €
additional chair / € 15 × / = / €
an armchair / € 35 × / = / €
additional lighting / € 10 × / = / €
a ventilation fan / € 20 × / = / €
a refrigerator (big) / € 120 × / = / €
a refrigerator (small) / € 80 × / = / €
a coat-stand / € 10 × / = / €
a waste-paper basket / € 5 × / = / €

2.3. Full colour pageadvertisement in Final Conference Programor Exhibitors Book (distributed among conference participants):

Inside front cover*) / €1500× / = / €
Inside back cover*)(full color page) / € 1500 × / = / €
Inside page or pages (full colorpage) / € 500 × / = / €

*)Advertisement space on front and back cover is assigned on a first come, first serve basis.

2.4. Distribution of information materials among conference participant:

Company’s leaflet or CD in all conference bags**) / €500 × / = / €

**)Information materials in the quantity of 400 each should be received by organizers not later than August30, 2016.

2.5. Social packet:

Additional invitation to cocktail, September 6, 2016(1st conference day) / €40× / = / €
Additional invitation to banquetSeptember 7, 2016 (2ndconference day) / € 90× / = / €
Lunch on September 5, 2016 / € 10 × / = / €
Additional lunch on September 6, 2016 / € 10 × / = / €
AdditionalLunch on September 7, 2016 / € 10 × / = / €
Additional Lunch on September 8, 2016 / € 10 × / = / €
Lunch on September 9, 2016 / € 10 × / = / €

3.The sum for services required:

Total payment (all prices including 23% Goods and Service Tax) / €

4.Exhibitor’s additional information and requests:

4.1. Delegates’ names with granted access to the exhibition only:

1.
2.
3.
4. / 5.
6.
7.
8.

4.2. Presentations and Workshops:

Our company is interested in organizing short company presentation (20 min) / YES / NO
Title of presentation:
Our company is interested in organizing workshop/tutorial
(proposals should be sent to organizers before March 17, 2016): / YES / NO
Names and contact information of authors or speakers:
Title of the workshop/tutorial:

4.3. Items to be exhibited:

No. / Name of item / Overall dim.
in cm / Weight
in kg
1.
2.
3.
4.
5.
6.
7.
8.

5. Additional requirements:

i.e. Electric power (50Hz - 220V): Power required (kW):

I hereby accept the general rules and charges for services. Charges or services included in application form will be paid for the bank account indicated in the invoice. The copy of the bank transfer confirmation should be sent byfax to: +48 71 3204352 or e-mail:

Date ______

Company's stamp

______

Signature

Organizers:
WroclawUniversity of Technology / EMC Europe 2016
WroclawUniversity of Technology, Faculty of Electronics
Department of Telecommunications and Teleinformatics
Wyb. Wyspiańskiego 27, 50-370 Wroclaw, POLAND
Phone: +48 71 3204352 Phone/Fax: +48 713223473

1 / 4