Registration Form

Before completing this form please read the conditions for registration here

“India and the Lusophone Market” International Congress
14 and 15 January 2014, Goa, India

* required fields

    *MrMs

    First name*

    Last name*

    Your email*

    Address*

    Phone (with country code)*

    Mobile phone (with country code)

    Your institution or company, with country*. If you don't belong to any please write "none".

    Your activity/responsability in your institution/company*. If not applicable please write "none".

    Subjects of your interest

    Registration Category* (prices valid until 31 December 2013)

    (Registration for "face-to-face" business networking only, is not possible)

    International delegate 350 USD
    Indian delegate 15000 INR
    'Face-to-face' business networking (International)* 250 USD
    'Face-to-face' business networking (Indian)* 10000 INR
    Accompanying person (international) 100 USD
    Accompanying person (Indian) 3000 INR
    Special Category (only for Indians) 1000 INR
    Indian student (Limited number) 500 INR

    In case you opted for an accompanying person, please give the name:

    MrMs

    First name of the accompanying person

    Last name of the accompanying person

    Any additional information you'd like to make:

    Will you require a headset for the simultaneous translation plenary sessions?

    NoYes

    Mode of payment: Payments by bank transfer will be accepted either in USD (or correspondent in Euro) or in INR in respective cases. You can also pay at:
    ALPHA CREATIVE
    502, Zarina Towers, A Block
    St Inez, Panjim-Goa. INDIA. 403001.
    Tel: 91-832-2420154
    Please make the payment when submitting this Form. Upon receipt of registration form and payment, confirmation of registration will be sent.

    For more information
    Please contact info@sh118.global.temp.domains or directly here

    Find details of how to make the payment here…