Event Registration Form

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Register me for :(View Prices)*

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CLICK HERE TO AUTO FILL THE FORM

VIP Number

Your VIP code is a five letter code (eg. VPZQG) that can be found on the promotional piece you have received (brochure, catalogue, fax, email).

How did you hear about this event?

Prefix*

First Name*

Last Name*

Job Title

Department

Company Name

Email*

I would like to receive information about future events & services via email.

Yes

Phone

Fax

Approving Manager

Company Address

City

PO Box

Country

Company Size

Industry

PAYMENT METHOD:

A confirmation letter and invoice will be sent upon receipt of your registration. Please note that full payment must be received prior to the event. Only those delegates whose fees have been paid in full will be admitted to the event.

Payment by company cheques or bankers draft must be in UAE Dirhams or US Dollars. Please note that all US cheques and bankers drafts should be drawn on a New York bank and an extra amount of US$6 per payment should be added to cover bank clearing charges.

All payments should be in favour of IIR Holdings Ltd.

NOTE: If payment through Credit Card, please fill in the Credit Card Information section below. This form is sent through a Secure Server. Credit Card transactions will be processed in UAE Dirhams at the exchange rate of US$1 = Dhs 3.67242. Credit Cards denominated in currencies besides UAE Dirhams will be charged as per issuing bank conversion rate.

Payment Method

by Credit Card

by Company Cheque

by Bank Transfer

by Bank Draft

Credit Card Information :

Name on Credit Card

Credit Card Type

Credit Card Number

Billing Address

Credit Card Expires On

Comments/Questions

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