Registration and Hotel Reservation Form - BIR
Registration and Hotel Reservation Form - BIR
Registration and Hotel Reservation Form - BIR
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<strong>Registration</strong> <strong>and</strong> <strong>Hotel</strong> <strong>Reservation</strong> <strong>Form</strong><strong>BIR</strong> World Recycling Convention * & ExhibitionSHANGHAI, (26) 27-29 May 2013Please return this form before 15 March 2013 to benefit from preferential registration fees <strong>and</strong> hotelroom rates:MCI GROUP ASIA PACIFIC • F. +65 6496 5599 • <strong>BIR</strong>2013shanghai@mci-group.comor visit www.bir.org to register online.Delegate / Délégué / Delegierter (in capital letters / en majuscules / in Großbuchstaben)Family name / Nom / Name AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAFirst name / Prénom / Vorname AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAACompany / Société / Firma AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAddress / Adresse / Adresse AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAACity / Ville / StadtAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAPost code / Code postal / Plz AAAAAAAA Country / Pays / L<strong>and</strong> AAAAAAAAAAAAAAAAAAAAAAAAAATelephoneAAAAAAAAAAAAAAAAAAAAA Fax AAAAAAAAAAAAAAAAAAAE-mailAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAWebsiteAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAMobile / CellAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAI authorize <strong>BIR</strong> to publish my mobile nr in the list of participants Yes q No qIf applicable, please add company VAT Number AAAAAAAAAAAAAAAAAAAAAAAAAASpouse / Conjoint / (Ehe)PartnerIn*Family name / Nom / Name AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAFirst name / Prénom / Vorname AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA* The spouse is not a delegate, she/he does not pay a fee <strong>and</strong> is not entitled to participate in the business sessions. For another delegate, use another formInterested in / Intéressé par / Interessiert an (Please tick / Veuillez cocher / Bitte ankreuzen)q 1. Ferrous / Ferrailles / Eisenq 5. Textiles / Textiles / Textilienq 2. Metals / Métaux / NE-Metalleq 6. Plastics / Plastiques / Kunststoffq 3. Stainless - Alloys / Aciers Inox Alliés / Rostfreie - Legierte Stähleq 7. Tyres / Pneus / Reifenq 4. Paper / Papiers / Papier<strong>Registration</strong> Status <strong>and</strong> Fees (in US$)<strong>BIR</strong> Gold Member company representative (in case of doubt please check with <strong>BIR</strong> Secretariat)Any other <strong>BIR</strong> Member companyFill in the appropriate boxbefore 15 March 2013 US$1650 US$after 15 March 2013 US$1800 US$before 15 March 2013 US$1800 US$after 15 March 2013 US$1950 US$Special Textiles, Plastics, Tyres (<strong>BIR</strong> members only) At all times US$1100 US$Young Traders under 35 – <strong>BIR</strong> members only (please attach copy of Id card /passport)) At all times US$1100 US$Observer At all times US$2250 US$Press – accredited journalists (by <strong>BIR</strong> invitation only)Guest / Speaker<strong>BIR</strong> National Association Representatives(applicable only to invited Presidents/Executive Directors)Spouse of a registered delegateComplimentaryComplimentaryComplimentaryComplimentaryTotal registrationUS$* This event is co-hosted by CNIA, co-organized by CMRA, <strong>and</strong> supported by the Chinese member associations of <strong>BIR</strong>: CRRA, CAMU <strong>and</strong> CMRA
Airport Pick-upMCI GROUP ASIA PACIFIC offers individual airport pick-up from the airports Pudong International <strong>and</strong> Hongqiao (prices see programme ‘Access’).This service will be invoiced separately.q I would like to take advantage of the airport pick-up.Payment / Paiement / Zahlungq Credit cardq Visa q MasterCard q AMEXI hereby authorize MCI GROUP ASIA PACIFIC to debit my credit card :Credit card number AAAA - AAAA - AAAA - AAAAExpiry date AA /AA CVV code AAAACard holder’s name (please print) AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAACard holder’s signatureq Bank transferAccount Name:MCI Group Asia Pacific Pte LtdAccount Number: 260-664438-178Bank Name:The Hong Kong <strong>and</strong> Shanghai Banking Corporation LimitedBank Address: 21 Collyer Quay, #01-00 HSBC Building, Singapore 049320Swift Code:HSBCSGSGReference:<strong>BIR</strong> Shanghai Convention + Name of the Company + Name of Delegate(s)I have read <strong>and</strong> herewith accept the terms <strong>and</strong> conditions of participation indicated in the provisional programme:DateSignatureCANCELLATION OF THE CONVENTION AND UNABILITY OF A REGISTERED DELEGATE TO ATTENDIn the case of strikes, flood, fire, “force majeure” or any other circumstances beyond the control of <strong>BIR</strong> resulting in the partial or complete cancellation of theconvention (<strong>and</strong> of any part of its programme), <strong>BIR</strong> cannot be held liable. No refund of the registration fees or of the hotel pre-payment/deposits will be made.<strong>BIR</strong> - REPRESENTING THE FUTURE LEADING RAW MATERIAL SUPPLIERSBureau of International Recycling (aisbl)Avenue Franklin Roosevelt 241050 BrusselsBelgiumT. +32 2 627 57 70F. +32 2 627 57 73bir@bir.orgwww.bir.org
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