Safeguard and Enhancing Company Value by Leveraging Supply Risk Management (Srim)

The EIPM Workshop

Tuesday 19th of March 2013

“Safeguard and Enhancing Company Value by Leveraging Supply Risk Management (SRiM)”

Tuesday, 19th of March 2013

With a Networking dinner on the evening of the 18th

WORKSHOP REGISTRATION FORM

Please print this form (one per participant) and return to:

Aroa Guinea- EMAIL:

FAX: +33 (0) 4 50 31 56 80

Yes, I will attend the EIPM Workshop

Yes, I will not be able to attend the EIPM Workshop but my colleague will

No, I will not be able to attend. Please consider me for future events

Participant information

Ms. Mrs. Mr.

Family Name: / First Name:
Job Title:
Company:
Address:
Postal Code: / City:
Country:
Tel: / Fax:
E-mail:

Event registration

Networking Dinner
Monday, 18thMarch 2013at 7pm
at L’Avenue in the Best Western Hotel / Workshop
Tuesday, 19thMarch 2013
from 08:30 – 17:30
Food restrictions/Vegetarian?
FEES (Includes dinner on the 18th, lunch, coffee breaks and documentation)
FREE for EIPM Club Members
EARLY fee 800€ (VAT excluded) paid before February28th
NORMAL fee 900€ (VAT excluded) from March 1st

Compulsory Invoicing Information

Purchase Order n°: / Your company VAT n°:
Invoicing dept. contact and Tel n°:
Invoicing address (if different from participant’s):
Address line 2:
City: / Postal Code:
Phone: / Fax:
How would you like to do the payment?
Credit Card(Diners card not accepted)
American Express MasterCard Visa
Cardholder’s name:
Number:
Expiry date: / Security code ( 3 digits on the back):
Cheque
Payable to EIPM - French Geneva Campus - Site d’Archamps- 74160 ARCHAMPS - France
Bank transfer in Euros payable to:
IMPORTANT: Please specify Invoice Number on transfer.
SARL EUROPEAN INSTITUTE OF PURCHASING MANAGEMENT
Bank: Crédit Agricole des Savoie 2, Place de la Libération BP95 – 74160
ST JULIEN EN GENEVOIS - FRANCE
Bank Code: 8106 - Sort Code: 00034 - Account n°: 341 626 74 050 - Key: 08
Swift Code: AGRI FR PP 881 - IBAN: FR76 1810 6000 3434 1626 7405 008
European VAT Number: FR 913930946 28

YOUR REGISTRATION WILL BE AUTOMATICALLLY CONFIRMED

UPON RECEIPT OF YOUR PAYMENT

CANCELLATION POLICY

All cancellations are to be made in writing. You may change the name of the participant at any time.

For cancellations received by February 15th2013, 50% of the amount due will be charged.

For any cancellations received afterFebruary 16th 2013, 100% of the amount will be charged.

Please note that NO REFUND will be made for cancellations due to problems with airline or train companies!

Agreement

I hereby confirm that I agree with the above terms and conditions

The European Institute of Purchasing Management

Bâtiment Le Mont Blanc II – French Geneva Campus – 74160 Archamps – France

Tel +33450 31 56 78 – Fax +33450 31 56 80 – 1/2 pages